Long-term thiazide use and risk of low-energy fractures among persons with Alzheimer’s disease—nested case-control study
|Author:||Taipale, H.1,2,3,4; Rysä, J.2; Hukkanen, J.5;|
1Kuopio Research Centre of Geriatric Care, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland
2School of Pharmacy, University of Eastern Finland, Kuopio, Finland
3Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
4Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, Kuopio, Finland
5Research Unit of Internal Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
6Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia
7Department of Orthopedics and Traumatology, Kuopio University Hospital, Kuopio, Finland
8Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, Kuopio, Finland
|Online Access:||PDF Full Text (PDF, 0.4 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2019070122413
|Publish Date:|| 2019-07-01
Summary: We investigated the association between thiazide use and the risk of low-energy fractures among community dwellers with Alzheimer’s disease. Longer use was associated with a decreased risk of low-energy fractures. This study extends the previous knowledge of reduced fracture risk of thiazides to persons with Alzheimer’s disease.
Introduction: To investigate the association between thiazide use and the risk of low-energy fractures (LEF), and hip fracture among community dwellers with Alzheimer’s disease (AD). No prior study has evaluated the effect of thiazides on LEF risk of AD patients.
Methods: LEF cases were identified from the MEDALZ study, including all community-dwelling persons diagnosed with AD in Finland 2005–2011. During the follow-up from AD diagnoses until the end of 2015, cases with LEF (N = 10,416) and hip fracture (N = 5578) were identified. LEF cases were matched with up to three controls without LEF, according to time since AD diagnosis, age and gender. Thiazide use identified from the Prescription register data was modeled with PRE2DUP method. Current use was defined in 0–30 days’ time window before the fracture/matching date, and duration of current use was assessed. The association between thiazide exposure and LEFs was assessed with conditional logistic regression.
Results: Current thiazide use was observed in 10.5% of LEF cases and 12.5% of controls. Current thiazide use was associated with a decreased risk of LEF (adjusted OR [aOR] 0.83, 95% CI 0.77–0.88). In terms of the duration of use, no association was observed with short-term use (< 1 year or 1–3 years), while longer use (> 3 years) was associated with a reduced risk of LEF (aOR 0.77, 95% CI 0.71–0.83) and hip fracture (aOR 0.68, 95% CI 0.60–0.78).
Conclusions: Our study extends the previous knowledge of reduced fracture risk of thiazides to persons with AD, a population with significantly increased background risk of fractures.
|Pages:||1481 - 1489|
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3121 General medicine, internal medicine and other clinical medicine
© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.