Benzodiazepine Users May Be at Increased Risk for Hip Fracture

Higher prescribing threshold may lower rate of hip fractures
Higher prescribing threshold may lower rate of hip fractures

Benzodiazepines and related drugs were found to increase the risk of hip fracture in patients with and without Alzheimer's disease (AD), however long-term hospital stay was more common in patients with AD, reported study authors from the University of Eastern Finland. Findings from the study were published in the Journal of the American Medical Directors Association.

Researchers set out to study the association between benzodiazepine and related drug use with hip fracture, post-fracture mortality, and duration of hospital stay in patients with and without AD. The retrospective study was based on the Medication Use and Alzheimer's Disease (MEDALZ) cohort that evaluated all community-dwelling persons diagnosed with AD in Finland during 2005–2011 (n=70,718) and their matched comparators without AD. The follow-up time was 5 years. 

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The final study population included those without prior benzodiazepine and related drug use, defined as use during the year preceding AD diagnosis or the corresponding matching date. Study authors measured the risk of hip fracture and 1-year mortality as well as a >4-month hospital stay post-fracture. 

The data showed benzodiazepine and related drug use increased the risk of hip fracture in patients with and without AD (adjusted hazard ratio 1.4 [95% CI: 1.2–1.7] and 1.6 [95% CI: 1.3–1.9], respectively). Use of these medications during hip fracture was also associated with a post-fracture hospital stay >4 months in patients with AD (adjusted odds ratio 1.9 [95% CI: 1.3–2.8]) but not in the matched comparators. 

One-year mortality, however, was not associated with benzodiazepine and related drug use during hip fracture. There was also no difference between the benzodiazepines and benzodiazepine-related drugs regarding the increased risk of hip fractures. 

The study's results suggest that a higher threshold in prescribing benzodiazepines and related drugs for neuropsychiatric symptoms may lower the rate of hip fractures and impact the length of hospital stay in patients with AD, the authors conclude. 

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