Association Between Sedative-Hypnotic Medication Use and Fall-Related Emergency Department Visits Among Older Adults

Background: Falls are a leading cause of injury and emergency department visits among older adults. Medication use, including sedative hypnotics, may influence fall risk, but findings remain inconsistent across clinical settings. Objective: This study examined the association between sedative hypnotic use and fall-related emergency department visits among older adults. Methods: A retrospective cross-sectional analysis was conducted using the National Hospital Ambulatory Medical Care Survey emergency department data from 2014 to 2020. The study included adults aged 65 years and older. Fall-related visits were identified using external cause-of-injury codes, and sedative use was defined using Multum therapeutic class codes. Survey-weighted descriptive analyses were performed, and group comparisons were assessed using survey-adjusted t-tests and chi-square tests. Multivariable, survey-weighted logistic regression was used to evaluate associations while adjusting for demographic and clinical factors. Results: The analytic sample included 21,227 visits, representing 155,790,536 weighted visits. Fall-related visits were more common among older individuals and those with dementia. Sedative use was associated with lower odds of fall-related visits after adjustment for covariates (adjusted odds ratio = 0.74; 95% confidence interval = 0.55-0.98; p = 0.034). Age and dementia were associated with higher odds, while male sex and non-Hispanic Black, Hispanic, and non-Hispanic other groups had lower odds compared with non-Hispanic White individuals. Conclusion: Sedative use was associated with lower odds of fall-related emergency visits in this population. These findings should be interpreted in the context of potential residual confounding and highlight the need for further research using longitudinal data.