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Antidepressant Use Increased Risk of Hip Fractures Among Elderly With Alzheimer's Disease

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Highlights
  • Antidepressants are used to manage chronic pain and behavioral and psychological symptoms of dementia apart from depression.
  • The risk of hip fractures among elderly with Alzheimer's Disease who used antidepressants was nearly double .

Antidepressant Use Increased Risk of Hip Fractures Among Elderly With Alzheimer's Disease

Antidepressant use nearly doubles the risk of hip fracture among community-dwelling persons with Alzheimer's disease.

This was according to a new study from the University of Eastern Finland.

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Antidepressants are used not only for the treatment of depression, but also to manage chronic pain, behavioral and psychological symptoms of dementia, including insomnia, anxiety and agitation.

If antidepressant use is necessary, researchers recommend regular monitoring of patients.

In addition, other risk factors for falling should be carefully considered during the antidepressant treatment.
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Study

The data for the study was based on the Finish register-based MEDALZ cohort.

The study population comprised of all community-dwelling persons diagnosed with Alzheimer's disease in Finland between 2005-2011, and their matched controls.

It included 50,491 persons with mean age 80 years and 100,982 persons without the disease. For each person with Alzheimer's disease, two controls without the disease were matched by age and sex.

The follow-up was 4 years from the date of Alzheimer's disease diagnosis or a corresponding date for controls.

Findings

The risk of hip fracture among controls was two times higher with antidepressant use.

But the relative number of hip fractures was higher among people with Alzheimer's disease compared to controls.

The increased risk was associated with all of the most frequently used antidepressant groups like:
  • selective serotonin reuptake inhibitors (SSRI drugs)
  • mirtazapine
  • selective noradrenaline reuptake inhibitors (SNRI drugs)
Even after adjusting for confounding factors like using other medications and chronic conditions that increased risk of fall or fractures, osteoporosis, socioeconomic status and history of psychiatric diseases the risk of hip fracture with antidepressant use continues to persist.

The increased risk of hip fractures with antidepressant use was highest at the beginning of antidepressant use and remained elevated even 4 years later.

The findings were published in the International Journal of Geriatric Psychiatry.

References

  1. Sanna Torvinen-Kiiskinen et al. Antidepressant use and risk of hip fractures among community-dwelling persons with and without Alzheimer's disease. International Journal of Geriatric Psychiatry; (2017) DOI: 10.1002/gps.4667


Source: Medindia

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