The use of benzodiazepines and related drugs increases the risk of hip fracture by 43 per cent in persons with Alzheimer’s disease, according to a new study from the University of Eastern Finland. The hip fracture risk was investigated in community-dwelling Finnish persons with Alzheimer’s disease.
In total, 21 per cent of persons with Alzheimer’s disease initiated benzodiazepine and related drug use during the study. During the period of drug use, 2.5 hip fractures occurred per 100 person-years – compared with 1.4 hip fractures per 100 person-years without drug use. The increase in hip fracture risk was highest during the first six months of drug use, and there was no difference within the drug group, as benzodiazepines increased the risk of fracture as much as benzodiazepine-related drugs.
Additionally, long-term hospital stays exceeding four months after hip fracture were more common in persons with Alzheimer’s disease who had used benzodiazepines and related drugs at the time of hip fracture, compared with those who had not used the drugs.
Treatment guidelines in different countries recommend that behavioural and psychological symptoms of dementia should be treated with non-pharmacological options. Benzodiazepines and related drugs can be used in infrequent or short-term treatment of symptoms. The results of this study highlight the importance of the guidelines to avoid adverse events associated with the medication.
The study was based on the MEDALZ (MEDication use and ALZheimer’s disease) cohort, including all Finnish persons diagnosed with Alzheimer’s disease between 2005 and 2011 (70,718 persons). The study involved 46,373 persons who had no history of hip fractures and who had not used benzodiazepines and related drugs during the year preceding the study. The follow-up time in the study was up to five years.
Source: University of Eastern Finland
Reference: Saarelainen, L., Tolppanen, A.-M., Koponen, M., (2016) Risk of hip fracture in benzodiazepine users with and without Alzheimer’s disease. J. Am. Med. Directors Assoc. doi: 10.1016/j.jamda.2016.09.019