Antidepressant use and risk of hip fractures among community‐dwelling persons with and without Alzheimer's disease

Torvinen-Kiiskinen, Sanna; Tolppanen, Anna‐Maija; Koponen, Marjaana; Tanskanen, Antti; Tiihonen, Jari; Hartikainen, Sirpa; Taipale, Heidi

doi:10.1002/gps.4667

Cited by 30 publications

(21 citation statements)

References 41 publications

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“…Importantly, several drugs were added to the drug‐disease and drug‐drug interactions tables (Tables and ). Notably, SNRIs were added to the list of antidepressant drug classes to avoid in persons with a history of falls or fractures . For this criterion, the level of evidence for opioids was changed to “moderate”; all other drugs remain at high.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, SNRIs were added to the list of antidepressant drug classes to avoid in persons with a history of falls or fractures. 19,20 For this criterion, the level of evidence for opioids was changed to "moderate"; all other drugs remain at high. Two new drug-drug interactions involving opioids were added, reflecting evidence of substantial harms that can occur when opioids are used concurrently with benzodiazepines or gabapentinoids.…”

Section: Strength Of Recommendationmentioning

confidence: 99%

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American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults

2019

J American Geriatrics Society

2,581

1,043

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The American Geriatrics Society (AGS) Beers Criteria® (AGS Beers Criteria®) for Potentially Inappropriate Medication (PIM) Use in Older Adults are widely used by clinicians, educators, researchers, healthcare administrators, and regulators. Since 2011, the AGS has been the steward of the criteria and has produced updates on a 3‐year cycle. The AGS Beers Criteria® is an explicit list of PIMs that are typically best avoided by older adults in most circumstances or under specific situations, such as in certain diseases or conditions. For the 2019 update, an interdisciplinary expert panel reviewed the evidence published since the last update (2015) to determine if new criteria should be added or if existing criteria should be removed or undergo changes to their recommendation, rationale, level of evidence, or strength of recommendation. J Am Geriatr Soc 67:674–694, 2019.

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Section: Discussionmentioning

confidence: 99%

Section: Strength Of Recommendationmentioning

confidence: 99%

American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults

2019

J American Geriatrics Society

2,581

1,043

View full text Add to dashboard Cite

show abstract

“…Psychotropic drugs, which have been previously shown to be associated with an increased risk of hip fractures were more commonly used by persons with hip fracture than their controls. Consistent to previous studies, persons with hip fracture were more likely to have epilepsy or previous fracture or stroke, which are also risk factors for falling .…”

Section: Discussionmentioning

confidence: 99%

“…Analyses were adjusted for age, sex, socioeconomic position, ≥90 hospital days during the follow‐up, cardiovascular diseases, diabetes, asthma/chronic obstructive pulmonary disease, glaucoma, rheumatoid arthritis, epilepsy; previous fracture, stroke, cancer, depression or bipolar syndrome, schizophrenia, substance abuse; use of acetylcholine esterase inhibitors, memantine, oral corticosteroids, bisphosphonates, antipsychotics, antidepressants, benzodiazepines and related drugs, opioids, antithrombotics and H2‐blockers. Covariates for adjustment, drugs and comorbidities associated with PPI use and hip fracture, were chosen based on literature . The results are reported as odds ratios (OR) with 95% CI and P values.…”

Section: Methodsmentioning

confidence: 99%

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Proton pump inhibitor use and risk of hip fractures among community‐dwelling persons with Alzheimer's disease—a nested case‐control study

Torvinen-Kiiskinen

Tolppanen

Koponen

et al. 2018

Aliment Pharmacol Ther

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Summary Background Hip fractures are a major health concern among older persons with Alzheimer's disease, who usually use many concomitant drugs for several diseases. Evidence of the association between proton pump inhibitor use and risk of hip fracture is contradictory. Aim To investigate whether the long‐term use of proton pump inhibitor is associated with risk of hip fractures among community‐dwelling persons with Alzheimer's disease. Methods In this nested case‐control study, the nationwide MEDALZ data were utilised. Community‐dwelling persons with Alzheimer's disease who encountered incident hip fracture (N = 4818; mean age 84.1) were included as cases. Four controls were matched for each case at the date of hip fracture (N = 19 235; mean age 84.0). The association between hip fracture and duration of current PPI use (ongoing use during 0‐30 days before the index date), and cumulative duration of use during 10 years before was investigated with conditional logistic regression. Results Long‐term or cumulative proton pump inhibitor use was not associated with an increased risk of hip fracture. Current proton pump inhibitor use was associated with an increased risk of hip fracture (adjusted OR 1.12, 95% CI 1.03‐1.22). The risk was increased in short‐term current use (<1 year) (adjusted OR 1.23, 95% CI 1.10‐1.37). Conclusions The increased risk of hip fracture was evident only in short‐term proton pump inhibitor use, but no association was found for long‐term or cumulative use. Thus, our findings do not support previous assumptions that long‐term proton pump inhibitor use would be associated with an increased risk of hip fractures.

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Impact of the iWHELD digital person‐centered care program on quality of life, agitation and psychotropic medications in people with dementia living in nursing homes during the COVID‐19 pandemic: A randomized controlled trial

McDermid,

Henley,

Corbett

et al. 2023

Alzheimer's & Dementia

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IntroductioniWHELD is a digital person‐centered care program for people with dementia in nursing homes adapted for remote delivery during the COVID‐19 pandemic.MethodsA 16‐week two‐arm cluster‐randomized controlled trial in 149 UK nursing homes compared iWHELD with treatment as usual (TAU). Primary outcome was the overall quality of life with secondary outcomes of agitation and psychotropic use.ResultsiWHELD conferred benefit to quality of life on the primary (F = 4.3, p = 0.04) and secondary measures of quality of life (F = 6.45, p = 0.01) and reduced psychotropic medication use (χ2 = 4.08, p = 0.04) with no worsening of agitation. Benefit was seen in participants who contracted COVID‐19, those with agitation at baseline, and those taking psychotropic medications.DiscussioniWHELD confers benefits to quality of life and key measures of well‐being, can be delivered during the challenging conditions of a pandemic, and should be considered for use alongside any emerging pharmacological treatment for neuropsychiatric symptoms.Highlights iWHELD is the only remote, digital delivery nursing home training programme for dementia care iWHELD improved quality of life in people with dementia and reduced antipsychotic use without worsening of agitation Residents who contracted Covid‐19 during the study also experienced benefits from iWHELD iWHELD offers a valuable, pandemic‐safe tool for improving dementia care

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Antidepressant use and risk of hip fractures among community‐dwelling persons with and without Alzheimer's disease

Abstract: Antidepressant use is associated with an increased risk of hip fracture among older persons. Copyright © 2017 John Wiley & Sons, Ltd.

Cited by 30 publications

References 41 publications

American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults

American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults

Proton pump inhibitor use and risk of hip fractures among community‐dwelling persons with Alzheimer's disease—a nested case‐control study

Impact of the iWHELD digital person‐centered care program on quality of life, agitation and psychotropic medications in people with dementia living in nursing homes during the COVID‐19 pandemic: A randomized controlled trial

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