ParkinsonCanadaV1, Main, Exploration, bibRecord, 000A78

Effect of Anticholinergic Medications on Falls, Fracture Risk, and Bone Mineral Density Over a 10-Year Period

Identifieur interne : 000A78 ( Main/Exploration ); précédent : 000A77; suivant : 000A79

Effect of Anticholinergic Medications on Falls, Fracture Risk, and Bone Mineral Density Over a 10-Year Period

Auteurs : Lisa-Ann Fraser [Canada] ; Jonathan D. Adachi [Canada] ; William D. Leslie [Canada] ; David Goltzman [Canada] ; Robert Josse [Canada] ; Jerilynn Prior [Canada] ; Stephanie Kaiser [Canada] ; Nancy Kreiger [Canada] ; Christopher S. Kovacs [Canada] ; Tassos P. Anastassiades [Canada] ; Alexandra Papaioannou [Canada]

Source :

The Annals of pharmacotherapy [ 1060-0280 ] ; 2014.

RBID : PMC:5127698

Abstract

Background

Many medications used in older adults have strong anticholinergic (ACH) properties, which may increase the risk of falls and fractures. Use of these medications was identified in a population-based Canadian cohort.

Objective

To identify the fall and fracture risk associated with ACH medication use.

Methods

Data collection and analysis were conducted at baseline, year 5, and year 10. Cross-sectional analyses were performed to examine associations between ACH medication use and falls. Time-dependent Cox regression was used to examine time to first nontraumatic fracture. Finally, change in bone mineral density (BMD) over 10 years was compared in ACH medication users versus nonusers.

Results

Strongly ACH medications were used by 618 of 7753 participants (8.0%) at study baseline, 592 (9.5%) at year 5, and 334 (7.7%) at year 10. Unadjusted ACH medication use was associated with falls at baseline (odds ratio = 1.50; 95% CI = 1.14–1.98; P = 0.004), but the association was no longer significant after covariate adjustment. Similar results occurred at years 5 and 10. ACH medication use was associated with increased incident fracture risk before (hazard ratio = 1.22; CI = 1.13–1.32; P < 0.001) but not after covariate adjustment. Mean (SD) change in femoral neck BMD T-score over 10 years, in those using ACH medications at both years 0 and 5, was −0.60 (0.63) in ACH users versus −0.49 (0.45) in nonusers (P = 0.041), but this was not significant after covariate adjustment.

Conclusions

ACH medications were not found to be independently associated with an increased risk of falling, fractures, or BMD loss. Rather, factors associated with ACH medication use explained the apparent associations.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5127698

DOI: 10.1177/1060028014535363
PubMed: 24816210
PubMed Central: 5127698

Affiliations:

Le document en format XML

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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Many medications used in older adults have strong anticholinergic (ACH) properties, which may increase the risk of falls and fractures. Use of these medications was identified in a population-based Canadian cohort.</p>
</sec>
<sec id="S2"><title>Objective</title>
<p id="P2">To identify the fall and fracture risk associated with ACH medication use.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">Data collection and analysis were conducted at baseline, year 5, and year 10. Cross-sectional analyses were performed to examine associations between ACH medication use and falls. Time-dependent Cox regression was used to examine time to first nontraumatic fracture. Finally, change in bone mineral density (BMD) over 10 years was compared in ACH medication users versus nonusers.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">Strongly ACH medications were used by 618 of 7753 participants (8.0%) at study baseline, 592 (9.5%) at year 5, and 334 (7.7%) at year 10. Unadjusted ACH medication use was associated with falls at baseline (odds ratio = 1.50; 95% CI = 1.14–1.98; <italic>P</italic>
 = 0.004), but the association was no longer significant after covariate adjustment. Similar results occurred at years 5 and 10. ACH medication use was associated with increased incident fracture risk before (hazard ratio = 1.22; CI = 1.13–1.32; <italic>P</italic>
 < 0.001) but not after covariate adjustment. Mean (SD) change in femoral neck BMD <italic>T</italic>
-score over 10 years, in those using ACH medications at both years 0 and 5, was −0.60 (0.63) in ACH users versus −0.49 (0.45) in nonusers (<italic>P</italic>
 = 0.041), but this was not significant after covariate adjustment.</p>
</sec>
<sec id="S5"><title>Conclusions</title>
<p id="P5">ACH medications were not found to be independently associated with an increased risk of falling, fractures, or BMD loss. Rather, factors associated with ACH medication use explained the apparent associations.</p>
</sec>
</div>
</front>
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La maladie de Parkinson au Canada (serveur d'exploration)

Effect of Anticholinergic Medications on Falls, Fracture Risk, and Bone Mineral Density Over a 10-Year Period

Effect of Anticholinergic Medications on Falls, Fracture Risk, and Bone Mineral Density Over a 10-Year Period

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Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

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Pour générer des pages wiki

	La maladie de Parkinson au Canada (serveur d'exploration)
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