Nonselective beta-blocker eye drops and the risk of fall-related injuries: a Danish nationwide new user, active comparator propensity score matched cohort study.

Background and aim Falls in older adults are a major health concern. Risk factors include medications, but uncertainty remains about potential fall risk-increasing drugs (FRIDs). This nationwide cohort study examined whether non-selective beta-blocker eye drops (timolol) increase the risk of fall-re...

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Published in:Age & Ageing Vol. 55; no. 4; pp. 1 - 10
Main Authors: Obling, Maria L, Ryg, Jesper, Lund, Lars C, Viberg, Bjarke, Reilev, Mette, Henriksen, Daniel P, Pedersen, Sidsel A
Format: Article
Published: Oxford University Press / USA Apr2026
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      pub: Oxford University Press / USA
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        10.1093/ageing/afag093
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        atl: Nonselective beta-blocker eye drops and the risk of fall-related injuries: a Danish nationwide new user, active comparator propensity score matched cohort study.
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        au:
          Obling, Maria L
          Ryg, Jesper
          Lund, Lars C
          Viberg, Bjarke
          Reilev, Mette
          Henriksen, Daniel P
          Pedersen, Sidsel A
        affil:
          Department of Clinical Pharmacology, Odense University Hospital, Odense, 5230, Region of Southern Denmark, Denmark
          Geriatric Research and Clinical Evidence (GRACE), Department of Internal Medicine Geriatric Section, Copenhagen University Hospital - Herlev and Gentofte Hospital, Herlev, 2730, Capital Region of Denmark, DenmarkGeriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, 5230, Region of Southern Denmark, DenmarkDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, 2200, Capital Region of Denmark, Denmark
          Department of Clinical Pharmacology, Odense University Hospital, Odense, 5230, Region of Southern Denmark, DenmarkDepartment of Public Health, University of Southern Denmark - Clinical Pharmacology and Pharmacy, Odense, 5230, Region of Southern Denmark, Denmark
          Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, 5000, Region of Southern Denmark, DenmarkDepartment of Clinical Research, University of Southern Denmark, Odense, 5230, Region of Southern Denmark, Denmark
          Department of Public Health, University of Southern Denmark, Odense, 5230, Region of Southern Denmark, DenmarkCentre for Suicide Research, Odense, 5000, Region of Southern Denmark, DenmarkUnit of Mental Health Research, Southwest Denmark, Department of Psychiatry, University of Southern Denmark, Aabenraa, 6200, Region of Southern Denmark, Denmark
          Department of Clinical Pharmacology, Odense University Hospital, Odense, 5230, Region of Southern Denmark, DenmarkDepartment of Clinical Research, University of Southern Denmark, Odense, 5230, Region of Southern Denmark, Denmark
      su:
        Denmark
        Age distribution
        Injury risk factors
        Wound care
        Timolol maleate
        Risk assessment
        Cutaneous therapeutics
        Mathematical variables
        Ophthalmic drugs
        Probability theory
        Questionnaires
        Descriptive statistics
        Longitudinal method
        Odds ratio
        Bone fractures
        Prostaglandins
        Research
        Synthetic drugs
        Comparative studies
        Confidence intervals
        Accidental falls
        Disease incidence
      sug:
        subj:
          Age distribution
          Denmark
          Pharmaceutical and medicine manufacturing
          Medicinal and Botanical Manufacturing
          Injury risk factors
          Wound care
          Timolol maleate
          Risk assessment
          Cutaneous therapeutics
          Mathematical variables
          Ophthalmic drugs
          Probability theory
          Questionnaires
          Descriptive statistics
          Longitudinal method
          Odds ratio
          Bone fractures
          Prostaglandins
          Research
          Synthetic drugs
          Comparative studies
          Confidence intervals
          Accidental falls
          Disease incidence
      keyword:
        beta-blocker eye drops
        beta-blockers
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        eyedrops
        fall-related injuries
        follow-up
        fractures
        FRIDs
        high-dimensional propensity score
        https://dx.doi.org/10.1093/ageing/afag093
        inLanguage:en
        older adult
        older people
        prostaglandins
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41980196/
        synthetic
        timolol
        beta-blocker eye drops
        beta-blockers
        copyrightHolder:British Geriatrics Society
        copyrightYear:2026
        eyedrops
        fall-related injuries
        follow-up
        fractures
        FRIDs
        high-dimensional propensity score
        https://dx.doi.org/10.1093/ageing/afag093
        inLanguage:en
        older adult
        older people
        prostaglandins
        publisher:Oxford University Press
        sameAs:https://pubmed.ncbi.nlm.nih.gov/41980196/
        synthetic
        timolol
      ab: Background and aim Falls in older adults are a major health concern. Risk factors include medications, but uncertainty remains about potential fall risk-increasing drugs (FRIDs). This nationwide cohort study examined whether non-selective beta-blocker eye drops (timolol) increase the risk of fall-related injuries compared to topical prostaglandin analogue (TPA) eye drops. Methods Using registry data from all Danish residents, we included individuals aged ≥65 years who initiated timolol (n  = 52 019) or TPA (n  = 72 885) between 1996 and 2023. Propensity score matching was applied to balance baseline characteristics. The primary outcome covered hospital-treated fall-related injuries while the secondary outcome was fall-related fractures specifically. Results No statistically significant differences were observed in the risk of fall-related injuries or fall-related fractures for timolol vs. TPA users at 14, 90 or 365 days of follow-up, before or after propensity score matching. Predefined subgroup analyses showed an increased risk of fall-related injuries among individuals aged ≥80 years [incidence rate ratio (IRR) 1.23, 95% CI 1.01–1.50] and among users of ≥3 FRIDs (IRR 1.20, 95% CI 1.01–1.44). Conclusion Our findings suggest that timolol eye drops are not associated with a significantly increased risk of fall-related injuries in the overall population of older adults. However, a marginally significant increased risk of fall-related injuries was seen among the oldest individuals and those concurrently using multiple FRIDs. These findings underscore the importance of considering a patient-centred approach when prescribing medications that could be potentially harmful.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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