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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>
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