A 2023 Cochrane Database review found moderate-certainty evidence that muscle relaxants may increase the risk of adverse events.
Primary adverse events are due to CNS depressant effects (dizziness, sedation) and anticholinergic effects.
Geriatric patients already have baseline unsteady gait, decreased coordination and cognitive changes.
A 2015 study showed that geriatric patients who took muscle relaxants were 2.25 times more likely to visit the ED for a fall or fracture and 1.5 times more likely to be hospitalized for a fall or fracture than patients who did not take these medications.
Risk is greatest in patients >65 years of age. This population was 1.32 times more likely to have an injury compared to patients who did not take skeletal muscle relaxants.
References
Alvarez CA, et al. Association of skeletal muscle relaxers and antihistamines on mortality, hospitalizations, and emergency department visits in elderly patients: a nationwide retrospective cohort study. BMC Geriatr. 2015;15:2.
