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Antidepressant use increased hip fracture risk among older patients
Hip fracture risk was most prominent at the start of antidepressant use.
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Older patients who used antidepressants had an increased risk of hip fracture, according to results of a study that compared the incidence of hip fracture among patients with vs. those without Alzheimer’s disease.
“Older community-dwelling persons are at about two times higher risk for hip fracture during the antidepressant use,” Sanna Torvinen-Kiiskinen, MSc(Pharm), of the Kuopio Research Centre of Geriatric Care and School of Pharmacy of the University of Eastern Finland, told Orthopedics Today.
Torvinen-Kiiskinen and her colleagues compared results of antidepressant use with nonuse among 50,491 patients with Alzheimer’s disease and among 100,982 patients without Alzheimer’s disease with a mean age of 80 years who were among the Finnish register-based MEDALZ – Medication use and AD – cohort. Hospitalization for hip fracture was the primary outcome measure.
Antidepressants were used in the study by 22.4% of patients with Alzheimer’s disease and 9.9% of patients without Alzheimer’s disease. These patients used selective serotonin reuptake inhibitors most often when they began taking antidepressant medication.
The age-adjusted hip fracture rate per 100 person-years during antidepressant use was 3.01 and 2.28, respectively among patients with vs. without Alzheimer’s disease. Hip fracture risk was greater in all patients who used antidepressants vs. patients who did not use these drugs. Researchers noted the risk of hip fracture was most prominent at the beginning of use, but it remained elevated for up to 4 years.
“The association between antidepressant use and hip fractures has been previously studied. However, in our study the significant association remained even after adjusting with other fall risk, increasing diseases and medications, history of severe psychiatric illnesses, socioeconomic status and history of substance abuse. The significantly increased risk was found among persons with and without Alzheimer’s disease, as well as with all frequently used antidepressant groups,” Torvinen-Kiiskinen said.
“The start of antidepressant medication should be carefully considered,” she said, noting the medications and other risks of falls need to be monitored regularly in these patients.
Torvinen-Kiiskinen said more effective hip fractures preventive interventions among older patients are needed. “Further studies are needed to find out whether there is a dose-response between antidepressant use and severe adverse events, such as hip fracture, among older persons.” – by Casey Tingle
- Reference:
- Torvinen-Kiiskinen S, et al. Int J Geriatr Psychiatry. 2017;doi:10.1002/gps.4667.
- For more information:
- Sanna Torvinen-Kiiskinen, MSc(Pharm), can be reached at PO Box 1627, FI-70211 Kuopio, Finland; email: sanna.torvinen-kiiskinen@uef.fi.
Disclosure: Torvinen-Kiiskinen reports she received a research grant from The Finnish Cultural Foundation.