Objective: To determine whether commonly used medications increase the risk of falling in elderly Australians living in nursing homes.

Design: Case-control study.

Setting: A 104-bed nursing home in western Sydney during 1990-1991.

Subjects: The cases comprised 71 people who had at least one fall during the 12-month study period; 55 people with no falls over the same period served as the control group. The mean age of subjects was 82 years.

Measures: Data included medication use in the 24 hours prior to a fall, and assessments of ambulatory status, and gait and balance problems. All data were abstracted from medical records.

Results: After adjusting for potential confounders (age, sex, health status, depression, dementia, incontinence, ambulatory status, gait and balance problems, length of stay and use of other medications), the use of antipsychotics was found to be an important risk factor for falls (odds ratio 4.4, 95% confidence interval 1.2-16.5).

Conclusions: Our results support the conclusion that antipsychotic medications increase the risk of falls among elderly Australians living in nursing homes. Health professionals should minimise the use of these medications.

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