Anticholinergic drugs use and risk of hip fracture in geriatric patients

Limited research exists regarding the effect of anticholinergic drugs on fracture in geriatric Japanese patients. The aim of the present study was to establish whether anticholinergic load affects hip fracture and to clarify the risk based on the Anticholinergic Risk Scale score among geriatric patients in a convalescent rehabilitation setting.

The present nested case-control study included consecutive geriatric patients admitted and discharged from the convalescent rehabilitation ward between 2010 and 2016. Participants were divided based on the presence or absence of hip fracture during hospitalization. Demographic data, laboratory data and the Functional Independence Measure were analyzed between groups. The primary outcome was the presence of hip fracture. Multiple logistic regression analysis was carried out to analyze the relationship between anticholinergic drug use and hip fracture.

In total, 601 participants (210 men, 391 women; interquartile range 73-85 years) were included in the present study. Multiple logistic regression analysis of hip fracture, adjusting for confounding factors, showed that anticholinergic drug use was independently and positively correlated with hip fracture. In particular, an increase in the Anticholinergic Risk Scale score by 2 points correlates with a 2.86-fold greater risk for hip fracture, and an increase of ≥3 points results in a 4.21-fold greater risk, both being statistically significant results.

Increased anticholinergic load during hospitalization might be a predictor of increased hip fracture in geriatric patients. Geriatr Gerontol Int 2018; 18: 1340-1344.