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Medications associated with dizziness or hypotension and adverse outcomes: an electronic health record study in older adults with dementia
Harsharon Kaur Sondh, Delia Bishara, Gayan Perera, Hitesh Shetty, Robert Stewart, Christoph S. Mueller. Age and Ageing, 2025-05-31
Topic: Risk, prevention and care in population studies
Of the patients, 82.2% were receiving at least one dizziness-associated medication and 71.2% at least one hypotension-associated medication. For each additional medication associated with dizziness or hypotension, there was a 4% increased risk of all-cause emergency hospitalisation. No associations were found with hospitalised falls specifically or with mortality or cognitive decline. Medications that potentially cause dizziness or hypotension were associated with an increased risk of hospitalisation, although not specifically hospitalisation caused by falls. More systematic attention should be paid to coprescribing around the time of dementia diagnosis and the potential for rationalising this to minimise adverse drug events.
Key findings
- Of the patients, 82.2% were receiving at least one dizziness-associated medication and 71.2% at least one hypotension-associated medication.
- For each additional medication associated with dizziness or hypotension, there was a 4% increased risk of all-cause emergency hospitalisation.
- No associations were found with hospitalised falls specifically or with mortality or cognitive decline.
- Medications that potentially cause dizziness or hypotension were associated with an increased risk of hospitalisation, although not specifically hospitalisation caused by falls.
- More systematic attention should be paid to coprescribing around the time of dementia diagnosis and the potential for rationalising this to minimise adverse drug events.
Why it matters
In this cohort study of older adults with dementia, each additional medication associated with dizziness or hypotension was linked to a 4% increased risk of all-cause emergency hospitalisation, but no association was found with hospitalised falls, mortality or cognitive decline. It concerns medication safety in people who already have dementia, not treatment, cure or prevention of the disease.
Study details
- Study designcohort study
- Participants210
- Effect size82.2%; 71.2%
- Evidence strengthModerate
How this study scored 53/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Age and Ageing) |
| Journal's citation record | 2 / 4 | Age and Ageing: journal h-index 231 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 210 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 4 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Christoph Mueller: h-index 35 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | King's College London: institution h-index 1,348 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40483728) |
| Free to read | 2 / 2 | Free to read |
| Total | 53 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Sondh, H. K., Bishara, D., Perera, G., Shetty, H., Stewart, R., & Mueller, C. S. (2025). Medications associated with dizziness or hypotension and adverse outcomes: an electronic health record study in older adults with dementia. Age and Ageing. https://doi.org/10.1093/ageing/afaf154
Vancouver
Sondh HK, Bishara D, Perera G, Shetty H, Stewart R, Mueller CS. Medications associated with dizziness or hypotension and adverse outcomes: an electronic health record study in older adults with dementia. Age and Ageing. 2025. doi:10.1093/ageing/afaf154. PMID: 40483728.
BibTeX
@article{sondh2025-40483728,
author = {Sondh, Harsharon Kaur and Bishara, Delia and Perera, Gayan and Shetty, Hitesh and Stewart, Robert and Mueller, Christoph S.},
title = {{Medications associated with dizziness or hypotension and adverse outcomes: an electronic health record study in older adults with dementia}},
journal = {Age and Ageing},
year = {2025},
doi = {10.1093/ageing/afaf154},
pmid = {40483728},
url = {https://doi.org/10.1093/ageing/afaf154}
}
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