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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effect of Anticholinergic Medications on Falls, Fracture Risk, and Bone Mineral Density Over a 10-Year Period</title><author><name sortKey="Fraser, Lisa Ann" sort="Fraser, Lisa Ann" uniqKey="Fraser L" first="Lisa-Ann" last="Fraser">Lisa-Ann Fraser</name><affiliation><nlm:aff id="A1">Western University, London, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Adachi, Jonathan D" sort="Adachi, Jonathan D" uniqKey="Adachi J" first="Jonathan D." last="Adachi">Jonathan D. Adachi</name><affiliation><nlm:aff id="A2">McMaster University, Hamilton, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Leslie, William D" sort="Leslie, William D" uniqKey="Leslie W" first="William D." last="Leslie">William D. Leslie</name><affiliation><nlm:aff id="A3">University of Manitoba, Winnipeg, MB, Canada</nlm:aff></affiliation></author><author><name sortKey="Goltzman, David" sort="Goltzman, David" uniqKey="Goltzman D" first="David" last="Goltzman">David Goltzman</name><affiliation><nlm:aff id="A4">McGill University, Montréal, QC, Canada</nlm:aff></affiliation></author><author><name sortKey="Josse, Robert" sort="Josse, Robert" uniqKey="Josse R" first="Robert" last="Josse">Robert Josse</name><affiliation><nlm:aff id="A5">University of Toronto, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Prior, Jerilynn" sort="Prior, Jerilynn" uniqKey="Prior J" first="Jerilynn" last="Prior">Jerilynn Prior</name><affiliation><nlm:aff id="A6">University of British Columbia, Vancouver, BC, Canada</nlm:aff></affiliation></author><author><name sortKey="Kaiser, Stephanie" sort="Kaiser, Stephanie" uniqKey="Kaiser S" first="Stephanie" last="Kaiser">Stephanie Kaiser</name><affiliation><nlm:aff id="A7">Dalhousie University, Halifax, NS, Canada</nlm:aff></affiliation></author><author><name sortKey="Kreiger, Nancy" sort="Kreiger, Nancy" uniqKey="Kreiger N" first="Nancy" last="Kreiger">Nancy Kreiger</name><affiliation><nlm:aff id="A5">University of Toronto, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Kovacs, Christopher S" sort="Kovacs, Christopher S" uniqKey="Kovacs C" first="Christopher S." last="Kovacs">Christopher S. Kovacs</name><affiliation><nlm:aff id="A8">Memorial University of Newfoundland, St John’s, NL, Canada</nlm:aff></affiliation></author><author><name sortKey="Anastassiades, Tassos P" sort="Anastassiades, Tassos P" uniqKey="Anastassiades T" first="Tassos P." last="Anastassiades">Tassos P. Anastassiades</name><affiliation><nlm:aff id="A9">Queen’s University, Kingston, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Papaioannou, Alexandra" sort="Papaioannou, Alexandra" uniqKey="Papaioannou A" first="Alexandra" last="Papaioannou">Alexandra Papaioannou</name><affiliation><nlm:aff id="A2">McMaster University, Hamilton, ON, Canada</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24816210</idno><idno type="pmc">5127698</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5127698</idno><idno type="RBID">PMC:5127698</idno><idno type="doi">10.1177/1060028014535363</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000863</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000863</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Effect of Anticholinergic Medications on Falls, Fracture Risk, and Bone Mineral Density Over a 10-Year Period</title><author><name sortKey="Fraser, Lisa Ann" sort="Fraser, Lisa Ann" uniqKey="Fraser L" first="Lisa-Ann" last="Fraser">Lisa-Ann Fraser</name><affiliation><nlm:aff id="A1">Western University, London, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Adachi, Jonathan D" sort="Adachi, Jonathan D" uniqKey="Adachi J" first="Jonathan D." last="Adachi">Jonathan D. Adachi</name><affiliation><nlm:aff id="A2">McMaster University, Hamilton, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Leslie, William D" sort="Leslie, William D" uniqKey="Leslie W" first="William D." last="Leslie">William D. Leslie</name><affiliation><nlm:aff id="A3">University of Manitoba, Winnipeg, MB, Canada</nlm:aff></affiliation></author><author><name sortKey="Goltzman, David" sort="Goltzman, David" uniqKey="Goltzman D" first="David" last="Goltzman">David Goltzman</name><affiliation><nlm:aff id="A4">McGill University, Montréal, QC, Canada</nlm:aff></affiliation></author><author><name sortKey="Josse, Robert" sort="Josse, Robert" uniqKey="Josse R" first="Robert" last="Josse">Robert Josse</name><affiliation><nlm:aff id="A5">University of Toronto, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Prior, Jerilynn" sort="Prior, Jerilynn" uniqKey="Prior J" first="Jerilynn" last="Prior">Jerilynn Prior</name><affiliation><nlm:aff id="A6">University of British Columbia, Vancouver, BC, Canada</nlm:aff></affiliation></author><author><name sortKey="Kaiser, Stephanie" sort="Kaiser, Stephanie" uniqKey="Kaiser S" first="Stephanie" last="Kaiser">Stephanie Kaiser</name><affiliation><nlm:aff id="A7">Dalhousie University, Halifax, NS, Canada</nlm:aff></affiliation></author><author><name sortKey="Kreiger, Nancy" sort="Kreiger, Nancy" uniqKey="Kreiger N" first="Nancy" last="Kreiger">Nancy Kreiger</name><affiliation><nlm:aff id="A5">University of Toronto, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Kovacs, Christopher S" sort="Kovacs, Christopher S" uniqKey="Kovacs C" first="Christopher S." last="Kovacs">Christopher S. Kovacs</name><affiliation><nlm:aff id="A8">Memorial University of Newfoundland, St John’s, NL, Canada</nlm:aff></affiliation></author><author><name sortKey="Anastassiades, Tassos P" sort="Anastassiades, Tassos P" uniqKey="Anastassiades T" first="Tassos P." last="Anastassiades">Tassos P. Anastassiades</name><affiliation><nlm:aff id="A9">Queen’s University, Kingston, ON, Canada</nlm:aff></affiliation></author><author><name sortKey="Papaioannou, Alexandra" sort="Papaioannou, Alexandra" uniqKey="Papaioannou A" first="Alexandra" last="Papaioannou">Alexandra Papaioannou</name><affiliation><nlm:aff id="A2">McMaster University, Hamilton, ON, Canada</nlm:aff></affiliation></author></analytic><series><title level="j">The Annals of pharmacotherapy</title><idno type="ISSN">1060-0280</idno><idno type="eISSN">1542-6270</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9203131</journal-id><journal-id journal-id-type="pubmed-jr-id">1999</journal-id><journal-id journal-id-type="nlm-ta">Ann Pharmacother</journal-id><journal-id journal-id-type="iso-abbrev">Ann Pharmacother</journal-id><journal-title-group><journal-title>The Annals of pharmacotherapy</journal-title></journal-title-group><issn pub-type="ppub">1060-0280</issn><issn pub-type="epub">1542-6270</issn></journal-meta><article-meta><article-id pub-id-type="pmid">24816210</article-id><article-id pub-id-type="pmc">5127698</article-id><article-id pub-id-type="doi">10.1177/1060028014535363</article-id><article-id pub-id-type="manuscript">CAMS6094</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Effect of Anticholinergic Medications on Falls, Fracture Risk, and Bone Mineral Density Over a 10-Year Period</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Fraser</surname><given-names>Lisa-Ann</given-names></name><degrees>MD, MSc</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Adachi</surname><given-names>Jonathan D.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Leslie</surname><given-names>William D.</given-names></name><degrees>MD, MSc</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Goltzman</surname><given-names>David</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Josse</surname><given-names>Robert</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Prior</surname><given-names>Jerilynn</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Kaiser</surname><given-names>Stephanie</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Kreiger</surname><given-names>Nancy</given-names></name><degrees>MPH, PhD</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Kovacs</surname><given-names>Christopher S.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>Anastassiades</surname><given-names>Tassos P.</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A9">9</xref></contrib><contrib contrib-type="author"><name><surname>Papaioannou</surname><given-names>Alexandra</given-names></name><degrees>MD, MSc</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><on-behalf-of>for the CaMos Research Group</on-behalf-of></contrib-group><aff id="A1"><label>1</label>Western University, London, ON, Canada</aff><aff id="A2"><label>2</label>McMaster University, Hamilton, ON, Canada</aff><aff id="A3"><label>3</label>University of Manitoba, Winnipeg, MB, Canada</aff><aff id="A4"><label>4</label>McGill University, Montréal, QC, Canada</aff><aff id="A5"><label>5</label>University of Toronto, ON, Canada</aff><aff id="A6"><label>6</label>University of British Columbia, Vancouver, BC, Canada</aff><aff id="A7"><label>7</label>Dalhousie University, Halifax, NS, Canada</aff><aff id="A8"><label>8</label>Memorial University of Newfoundland, St John’s, NL, Canada</aff><aff id="A9"><label>9</label>Queen’s University, Kingston, ON, Canada</aff><author-notes><corresp id="FN1">Corresponding Author: Lisa-Ann Fraser, Division of Endocrinology and Metabolism, St Joseph’s Health Care, 268 Grosvenor Street, London, ON N6A 4V2, Canada. <email>LisaAnn.Fraser@sjhc.london.on.ca</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>27</day><month>10</month><year>2016</year></pub-date><pub-date pub-type="epub"><day>9</day><month>5</month><year>2014</year></pub-date><pub-date pub-type="ppub"><month>8</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>29</day><month>11</month><year>2016</year></pub-date><volume>48</volume><issue>8</issue><fpage>954</fpage><lpage>961</lpage><pmc-comment>elocation-id from pubmed: 10.1177/1060028014535363</pmc-comment>
<permissions><license license-type="permissions-link"><license-p>Reprints and permissions: <ext-link ext-link-type="uri" xlink:href="sagepub.com/journalsPermissions.nav">sagepub.com/journalsPermissions.nav</ext-link></license-p></license></permissions><abstract><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></abstract><kwd-group><kwd>anticholinergic medications</kwd><kwd>fracture</kwd><kwd>bone mineral density</kwd><kwd>falls</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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