Association between Anti-Psychotic Drugs Use and Hip Fractures in Patients with Dementia: A Nationwide Population-Based Study

Chia-Hung Tang, Yi-Chen Lai, Yi-Chen Chen, Shun-Min Chang, Yu-Han Chen, Jung-Yu Liao, Yi-Chi Wang, Chung-Han Ho and Ping-Jen Chen
Additional contact information
Chia-Hung Tang: Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan 700, Taiwan
Yi-Chen Lai: Department of Emergency Medicine, An Nan Hospital, China Medical University, Tainan 709, Taiwan
Yi-Chen Chen: Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan
Shun-Min Chang: Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung 801, Taiwan
Yu-Han Chen: Department of Family Medicine, Chi-Mei Medical Center, Tainan 710, Taiwan
Jung-Yu Liao: Department of Public Health, Kaohsiung Medical University, Kaohsiung 807, Taiwan
Yi-Chi Wang: Department of Family Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
Chung-Han Ho: Department of Medical Research, Chi Mei Medical Center, Tainan 710, Taiwan
Ping-Jen Chen: Division of Psychiatry, University College London, London W1T 7NF, UK

IJERPH, 2021, vol. 18, issue 15, 1-12

Abstract: Background: People with dementia are a high-risk group for hip fractures. Although the increased risk of hip fractures associated with antipsychotic drugs (APD) is found in older populations, little is known about the risk for people with dementia living in Asia. We aimed to investigate the association between hip fractures and the characteristics of APD use in patients with dementia. Methods: A nested case-control analysis was conducted on a nationwide cohort in Taiwan. People with diagnoses of dementia during 2003–2012 were identified. Conditional logistic regression analysis was performed, and adjusted odds ratios (aORs) were calculated with a 95% confidence interval (CI) to estimate the risk of hip fractures. Results: APD use was associated with an increased risk of hip fractures in patients with dementia; current use or combined use of first and second generations of APDs had even higher risks. Regarding the duration of APD use, a U-shape curve of hip fracture risk was noted, and the risk peaked during 0–15 days and >215 days of exposure (aOR = 1.46, 95% CI 1.37–1.57; aOR = 1.47, 95% CI 1.37–1.58; respectively). Considering the doses of APDs, the hip fracture risk was significantly increased with all four levels of the cumulative doses and average daily doses and peaked in the group with the highest average daily dose. Conclusions: The findings suggest that caution must be taken when initiating APD use in patients with dementia, even in a small dose, and mixed types of APD prescriptions should be administered with care. Furthermore, frequent evaluation of the possibility of tapering or withdrawal of the medication is necessary, as the risk does not attenuate after long-term use.

Keywords: antipsychotic drugs; dementia; hip fracture; epidemiology; national health program (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/15/8118/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/15/8118/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:15:p:8118-:d:605966

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().