Sanna Torvinen-Kiiskinen1,2, Anna-Maija Tolppanen2,3, Marjaana Koponen1,2, Antti Tanskanen4,5,6, Jari Tiihonen4,5, Sirpa Hartikainen1,2,7, Heidi Taipale1,2,4. 1. Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland. 2. School of Pharmacy, University of Eastern Finland, Kuopio, Finland. 3. Research Centre for Comparative Effectiveness and Patient Safety (RECEPS), University of Eastern Finland, Kuopio, Finland. 4. Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 5. Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland. 6. National Institute for Health and Welfare, Helsinki, Finland. 7. Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland.
Abstract
OBJECTIVE: To study whether antidepressant use is associated with an increased risk of hip fracture among community-dwelling persons with and without Alzheimer's disease (AD), and to compare the risk according to duration of use and between antidepressant groups. METHODS: Retrospective cohort study, including 50,491 persons with AD (mean age 80) and 100,982 comparison persons without AD from Finnish register-based MEDALZ cohort. Antidepressant use was compared with nonuse with Cox proportional hazard models. Incident users were identified with a one year washout period from Prescription register data. Main outcome was hospitalization due to hip fracture. RESULTS: During antidepressant use, the age-adjusted rate of hip fractures per 100 person-years was 3.01 (95% CI 2.75-3.34) among persons with and 2.28 (1.94-2.61) among persons without AD. Antidepressant use was associated with an increased risk of hip fracture among persons with and without AD (adjusted HR 1.61, 95% CI 1.45-1.80 and 2.71, 2.35-3.14, respectively) compared with nonuse. The risk was most prominent in the beginning of use and was elevated even up to 4 years. The risk was increased with all of the most frequently used antidepressants. CONCLUSION: Antidepressant use is associated with an increased risk of hip fracture among older persons.
OBJECTIVE: To study whether antidepressant use is associated with an increased risk of hip fracture among community-dwelling persons with and without Alzheimer's disease (AD), and to compare the risk according to duration of use and between antidepressant groups. METHODS: Retrospective cohort study, including 50,491 persons with AD (mean age 80) and 100,982 comparison persons without AD from Finnish register-based MEDALZ cohort. Antidepressant use was compared with nonuse with Cox proportional hazard models. Incident users were identified with a one year washout period from Prescription register data. Main outcome was hospitalization due to hip fracture. RESULTS: During antidepressant use, the age-adjusted rate of hip fractures per 100 person-years was 3.01 (95% CI 2.75-3.34) among persons with and 2.28 (1.94-2.61) among persons without AD. Antidepressant use was associated with an increased risk of hip fracture among persons with and without AD (adjusted HR 1.61, 95% CI 1.45-1.80 and 2.71, 2.35-3.14, respectively) compared with nonuse. The risk was most prominent in the beginning of use and was elevated even up to 4 years. The risk was increased with all of the most frequently used antidepressants. CONCLUSION: Antidepressant use is associated with an increased risk of hip fracture among older persons.
Authors: Danijela Gnjidic; George O Agogo; Christine M Ramsey; Daniela C Moga; Heather Allore Journal: J Gerontol A Biol Sci Med Sci Date: 2018-09-11 Impact factor: 6.053