Dopaminergic drugs and the risk of hip or femur fracture: a population-based case–control study

Arbouw, Maurits E. L.; Movig, Kris L. L.; Staa, Tjeerd van; Egberts, Toine C. G.; Souverein, Patrick C.; Vries, Frank de

doi:10.1007/s00198-010-1455-3

Cited by 31 publications

(26 citation statements)

References 42 publications

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“…The predisposition for hip fractures in PD may reflect the nature of the falls themselves in that they are often in a sideways or backward direction 2931 Elderly subjects with a rapid gait are more likely to fall forward while those with a shuffling gait tend to fall backward or to the side and suffer a hip fracture 4142 Lower BMD levels at the hip may also contribute to the excess rate of hip fractures in PD patients.…”

Section: Discussionmentioning

confidence: 99%

“…44 Alongside a possible deleterious effect on BMD, levodopa improves some motor deficits in PD but tends not to improve postural stability, meaning that patients are potentially more mobile but are perhaps at an increased risk of falls. Side effects of levodopa such as orthostatic hypotension, visual hallucinations and excessive daytime somnolence can further increase risk of falls 41. Levodopa can also induce hyperhomocysteinemia which has been reported as a potential risk factor for fractures 45.…”

Section: Discussionmentioning

confidence: 99%

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Bone health in Parkinson's disease: a systematic review and meta-analysis

Torsney

Noyce²,

Doherty³

et al. 2014

J Neurol Neurosurg Psychiatry

127

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ObjectiveParkinson's disease (PD) and osteoporosis are chronic diseases associated with increasing age. Single studies have reported associations between them and the major consequence, namely, increased risk of fractures. The aim of this systematic review and meta-analysis was to evaluate the relationship of PD with osteoporosis, bone mineral density (BMD) and fracture risk.MethodsA literature search was undertaken on 4 September 2012 using multiple indexing databases and relevant search terms. Articles were screened for suitability and data extracted where studies met inclusion criteria and were of sufficient quality. Data were combined using standard meta-analysis methods.Results23 studies were used in the final analysis. PD patients were at higher risk of osteoporosis (OR 2.61; 95% CI 1.69 to 4.03) compared with healthy controls. Male patients had a lower risk for osteoporosis and osteopenia than female patients (OR 0.45; 95% CI 0.29 to 0.68). PD patients had lower hip, lumbar spine and femoral neck BMD levels compared with healthy controls; mean difference, −0.08, 95% CI −0.13 to −0.02 for femoral neck; −0.09, 95% CI −0.15 to −0.03 for lumbar spine; and −0.05, 95% CI −0.07 to −0.03 for total hip. PD patients were also at increased risk of fractures (OR 2.28; 95% CI 1.83 to 2.83).ConclusionsThis systematic review and meta-analysis demonstrate that PD patients are at higher risk for both osteoporosis and osteopenia compared with healthy controls, and that female patients are at greater risk than male patients. Patients with PD also have lower BMD and are at increased risk of fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bone health in Parkinson's disease: a systematic review and meta-analysis

Torsney

Noyce²,

Doherty³

et al. 2014

J Neurol Neurosurg Psychiatry

127

View full text Add to dashboard Cite

show abstract

“…The association between fracture and Parkinson’s disease may be because falls are common among these patients [14]. Koller et al [18] reported that 38% of Parkinson’s disease patients reported falls and 13% fell more than once a week; these patients may have reduced sunlight exposure and a lower dietary intake of calcium and vitamin D. The use of dopaminergic drugs in many Parkinson’s disease patients has also been shown to be a contributory factor to fracture risk [19]. …”

Section: Discussionmentioning

confidence: 99%

Effect of co-morbidities on fracture risk: Findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW)

Dennison

Compston

Flahive

et al. 2012

Bone

141

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Introduction Greater awareness of the relationship between co-morbidities and fracture risk may improve fracture-prediction algorithms such as FRAX. Materials and methods We used a large, multinational cohort study (GLOW) to investigate the effect of co-morbidities on fracture risk. Women completed a baseline questionnaire detailing past medical history, including co-morbidity history and fracture. They were re-contacted annually to determine incident clinical fractures. A co-morbidity index, defined as number of baseline co-morbidities, was derived. The effect of adding the co-morbidity index to FRAX risk factors on fracture prevention was examined using chi-squared tests, the May-Hosmer test, c index and comparison of predicted versus observed fracture rates. Results Of 52,960 women with follow-up data, enrolled between October 2006 and February 2008, 3224 (6.1%) sustained an incident fracture over 2 years. All recorded co-morbidities were significantly associated with fracture, except for high cholesterol, hypertension, celiac disease, and cancer. The strongest association was seen with Parkinson’s disease (age-adjusted hazard ratio [HR]: 2.2; 95% CI: 1.6–3.1; P<0.001). Co-morbidities that contributed most to fracture prediction in a Cox regression model with FRAX risk factors as additional predictors were: Parkinson’s disease, multiple sclerosis, chronic obstructive pulmonary disease, osteoarthritis, and heart disease. Conclusion Co-morbidities, as captured in a co-morbidity index, contributed significantly to fracture risk in this study population. Parkinson’s disease carried a particularly high risk of fracture; and increasing co-morbidity index was associated with increasing fracture risk. Addition of co-morbidity index to FRAX risk factors improved fracture prediction.

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“…Another report of similar finding was that of van den Brand et al [ 55 ] who found that current use of both SSRIs and TCAs increased hip or femur fracture risk. Arbouw et al [ 56 ] also found that current use of dopaminergic drugs (1–30 days before the index date) was associated with an increased risk of hip or femur fractures, but the risk rapidly decreased to baseline levels when treatment was discontinued for more than 1 year. Another reason for the discrepancy in results is that we only examined HF, whereas most of previous studies investigated all fractures.…”

Section: Discussionmentioning

confidence: 99%

Effects of depression and antidepressant medications on hip fracture

Cheng

Chen

Yang³

et al. 2016

Medicine

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This study was conducted to investigate the effects of depression and antidepressant medications on hip fracture. The database of the Taiwan National Health Insurance with medical records of more than 1,000,000 individuals was searched for patients who had hip fracture with or without depression from 1998 to 2009. Patients with the following conditions were excluded: hip fracture due to cancer or traffic accidents, hip fracture that occurred before the diagnosis of depression, and use of antidepressants before the diagnosis of depression. A matched cohort of 139,110 patients was investigated, including 27,822 (17,309 females; 10,513 males) with depression and 111,288 (69,236 females; 42,052 males) without depression (1:4 randomly matched with age, sex, and index date). Among these patients, 232 (158 females and 74 males) had both hip fracture and depression, and 690 (473 females and 217 males) had hip fracture only. The Cox proportional-hazards regression method was used to determine the effect of depression on hip fracture. The hazard ratio (HR) for each clinical parameter was calculated after adjusting for confounders including sex, age, Charlson comorbidity index, urbanization, osteoporosis, and antidepressants. Results showed that patients with major depressive disorder had a 61% higher incidence of hip fracture than those without depression (HR 1.61, 95% confidence interval [CI] 1.19–2.18, P = 0.002). The risk of hip fracture for patients with less severe depressive disorder (dysthymia or depressive disorder, not otherwise specified) was not statistically higher than that of patients with no depression (HR 1.10, 95% CI = 0.91–1.34, P = 0.327). Among the patients with depression, females had a 49% higher incidence for hip fracture than males (HR 1.49, 95% CI 1.30–1.72, P < 0.001). The incidence of hip fracture also increased with age and Charlson comorbidity index scores. Analyses of both all (139,110) patients and only patients (27,822) with depression revealed that antidepressants had no negative impact on the incidence of hip fracture. In conclusion, major depression was found to be a risk factor for hip fracture and that use of antidepressants had no adverse effect on hip fracture in the Taiwanese population.

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Dopaminergic drugs and the risk of hip or femur fracture: a population-based case–control study

Cited by 31 publications

References 42 publications

Bone health in Parkinson's disease: a systematic review and meta-analysis

Bone health in Parkinson's disease: a systematic review and meta-analysis

Effect of co-morbidities on fracture risk: Findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW)

Effects of depression and antidepressant medications on hip fracture

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