Danish register-based study on the association between specific antipsychotic drugs and fractures in elderly individuals
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Danish register-based study on the association between specific antipsychotic drugs and fractures in elderly individuals. / Torstensson, Maia; Leth-Møller, Katja; Andersson, Charlotte; Torp-Pedersen, Christian; Gislason, Gunnar Hilmar; Holm, Ellen Astrid.
In: Age and Ageing, Vol. 46, No. 2, 01.03.2017, p. 258-264.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Danish register-based study on the association between specific antipsychotic drugs and fractures in elderly individuals
AU - Torstensson, Maia
AU - Leth-Møller, Katja
AU - Andersson, Charlotte
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar Hilmar
AU - Holm, Ellen Astrid
N1 - © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background: antipsychotic drugs (APs) have been associated with falls and fractures in elderly individuals but limited knowledge on specific drugs exist.Objective: to investigate the association between individual APs and fractures in elderly persons.Design and setting: nationwide register-based cohort study.Subjects: all Danish individuals aged ≥65 who had not been in treatment with any AP in the year before inclusion.Methods: incidence rate ratios (IRRs) of fractures of hip, pelvis or upper extremities during treatment with commonly used APs were assessed in multivariable Poisson models. Exposure was divided into time periods from initiation of treatment: 0-30 days, 31-365 days or >365 days.Results: one year prior to inclusion, 1,540,915 individuals ≥65 years had not received APs and of these 93,298 initiated treatment with APs. Mean follow-up was 9.6 years. During follow-up, 246,057 (16%) experienced a fracture. Associations were for all APs highest in the initial treatment period (0-30 days) with IRRs for risperidone 1.97 (95% CI: 1.70-2.28), olanzapine 2.31 (95% CI: 1.96-2.73), quetiapine 2.09 (95% CI: 1.73-2.52), zuclopenthixol 2.19 (95% CI: 1.82-2.63), chlorprothixen 1.62 (95% CI: 1.18-2.24), flupenthixol 1.43 (95% CI: 1.06-1.93), levomepromazine 1.19 (95% CI 0.86-1.66), haloperidol 2.98 (95% CI 2.57-3.45), compared with the background population.Conclusions: use of APs is associated with fractures in elderly persons especially in the initial treatment period. If AP use in an elderly person is deemed necessary, individual falls prophylaxis should be considered.
AB - Background: antipsychotic drugs (APs) have been associated with falls and fractures in elderly individuals but limited knowledge on specific drugs exist.Objective: to investigate the association between individual APs and fractures in elderly persons.Design and setting: nationwide register-based cohort study.Subjects: all Danish individuals aged ≥65 who had not been in treatment with any AP in the year before inclusion.Methods: incidence rate ratios (IRRs) of fractures of hip, pelvis or upper extremities during treatment with commonly used APs were assessed in multivariable Poisson models. Exposure was divided into time periods from initiation of treatment: 0-30 days, 31-365 days or >365 days.Results: one year prior to inclusion, 1,540,915 individuals ≥65 years had not received APs and of these 93,298 initiated treatment with APs. Mean follow-up was 9.6 years. During follow-up, 246,057 (16%) experienced a fracture. Associations were for all APs highest in the initial treatment period (0-30 days) with IRRs for risperidone 1.97 (95% CI: 1.70-2.28), olanzapine 2.31 (95% CI: 1.96-2.73), quetiapine 2.09 (95% CI: 1.73-2.52), zuclopenthixol 2.19 (95% CI: 1.82-2.63), chlorprothixen 1.62 (95% CI: 1.18-2.24), flupenthixol 1.43 (95% CI: 1.06-1.93), levomepromazine 1.19 (95% CI 0.86-1.66), haloperidol 2.98 (95% CI 2.57-3.45), compared with the background population.Conclusions: use of APs is associated with fractures in elderly persons especially in the initial treatment period. If AP use in an elderly person is deemed necessary, individual falls prophylaxis should be considered.
KW - Accidental Falls
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Antipsychotic Agents/adverse effects
KW - Denmark/epidemiology
KW - Female
KW - Fractures, Bone/diagnosis
KW - Humans
KW - Incidence
KW - Male
KW - Registries
KW - Risk Factors
KW - Time Factors
U2 - 10.1093/ageing/afw209
DO - 10.1093/ageing/afw209
M3 - Journal article
C2 - 27932365
VL - 46
SP - 258
EP - 264
JO - Age and Ageing
JF - Age and Ageing
SN - 0002-0729
IS - 2
ER -
ID: 194776622