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Benzodiazepines and hip fractures in elderly people: case-control study
C Pierfitte1, G Macouillard, M Thicoïpe
1Département de Pharmacologie, Unité de Pharmacologie Clinique, Centre Hospitalier Universitaire de Bordeaux, 33076 Bordeaux Cedex, France.
BMJ (Clinical Research Ed.)
|March 27, 2001
Summary
Benzodiazepine use, except for lorazepam, did not increase hip fracture risk in older adults. Study highlights how exposure assessment methods impact findings in case-control research.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Epidemiology
Background:
- Benzodiazepines are commonly prescribed for older adults.
- Hip fractures are a significant cause of morbidity and mortality in the elderly.
Purpose of the Study:
- To investigate the association between benzodiazepine use and hip fracture risk in individuals over 65.
- To explore the influence of different exposure assessment methods on study outcomes.
Main Methods:
- A case-control study was conducted with 245 hip fracture cases and 817 matched controls.
- Exposure to benzodiazepines was assessed using questionnaires, medical records, and plasma samples.
- Potential confounding factors and lifestyle variables were also evaluated.
Main Results:
- Overall benzodiazepine use was not linked to an increased hip fracture risk (OR 0.9, 95% CI 0.5-1.5).
- Use of multiple benzodiazepines showed an association when assessed via questionnaires/records, but not plasma samples.
- Lorazepam was the only specific drug significantly associated with higher hip fracture risk (OR 1.8, 95% CI 1.1-3.1).
Conclusions:
- Benzodiazepine presence in plasma, excluding lorazepam, is not associated with hip fracture risk in the elderly.
- The method of determining drug exposure is critical and can affect the interpretation of case-control study results.