Z-drugs and falls in nursing home patients: data from the INCUR study

Background Z-drugs are the most prescribed treatment for insomnia, but their negative effect on the body sway can increase the risk of falls. Aims Evaluating the association between Z-drugs and falls in a resident cohort. Methods Prospective observational study using the data collected in the Incidence of pNeumonia and related ConseqUences in nursing home Residents (INCUR) study. Results During the one-year follow-up, among the 800 participants (median age 87), 93 individuals fell (64 fracturing and 29 without fracturing). Lower calf circumference (adjusted OR 0.92, 95% CI 0.86-0.97, p = 0.006) and the use of selective serotonin reuptake inhibitors (adjusted OR 1.86, 95% CI 1.1-3.05, p = 0.01) predicted falls, whereas the use of Z-drugs (adjusted OR 2.37, 95% CI 1.13-4.94, p = 0.02) and lower body mass index (adjusted OR 0.9, 95% CI 0.84-0.97, p = 0.005) were associated with falls without fractures. Conclusions Z-drugs predicted falls without fractures in residents. Alternative strategies to promote sleep in residents should be pursued.