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

• Published in: International journal of geriatric psychiatry Vol. 32; no. 12; pp. e107 - e115
• Main Authors: Torvinen‐Kiiskinen, Sanna, Tolppanen, Anna‐Maija, Koponen, Marjaana, Tanskanen, Antti, Tiihonen, Jari, Hartikainen, Sirpa, Taipale, Heidi
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.12.2017
• Subjects: Aged; Aged, 80 and over; Alzheimer disease; Alzheimer Disease - complications; Alzheimer's disease; Antidepressants; Antidepressive Agents - therapeutic use; drug utilization; Female; Finland - epidemiology; Fractures; Geriatric psychiatry; Hip; hip fractures; Hip Fractures - epidemiology; Hip joint; Hospitalization - statistics & numerical data; Humans; Male; Medicin och hälsovetenskap; Neurodegenerative diseases; Proportional Hazards Models; Retrospective Studies; Risk Factors; antidepressants; drug utilization; hip fractures; Alzheimer disease
• ISSN: 0885-6230; 1099-1166; 1099-1166
• DOI: 10.1002/gps.4667

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. Copyright © 2017 John Wiley & Sons, Ltd.