Psychotropics, thiazide diuretics and hip fractures in the elderly.
OBJECTIVE
To determine whether psychotropic medications increase, and thiazide diuretics decrease, the risk of hip fractures in elderly Australians.


METHODS
Population-based case-control study.


METHODS
The population aged 65 years and over living in a defined area in western Sydney, Australia, during 1990-1991. Cases (n = 209) were recruited from hospitals and controls (n = 207) were selected by an area probability sampling method, with additional sampling from nursing homes. Response rates were 96% for cases and 84% for controls.


METHODS
Data were collected directly from subjects by questionnaire; a proxy respondent was required for 27% of subjects. In addition to medication use, information was also collected on potential confounders: alcohol consumption, body mass index, cognitive status, dairy product consumption, health status, physical activity, smoking history and type of residence.


RESULTS
The use of temazepam, a short-acting benzodiazepine, was associated with an increase in the risk of hip fracture--odds ratio, adjusted for age, gender and residence is 3.78; 95% confidence interval (CI), 1.60-8.92. After adjusting for multiple potential confounders by logistic regression, the odds ratio for temazepam use was 3.52. There was a non-significant (P > 0.05) increase in hip fracture risk associated with the use of antidepressants and antipsychotics. Thiazide diuretics were not associated with a risk of hip fracture--the multivariate-adjusted odds ratio was 0.98 (95% CI, 0.49-1.99).


CONCLUSIONS
Temazepam may increase the risk of hip fracture in elderly people. The effect of thiazide diuretics on fracture risk should be assessed in a large randomised trial.
Cumming
R G
RG
Department of Public Health, University of Sydney, NSW.
Klineberg
R J
RJ
D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001581:Benzothiadiazines; D016022:Case-Control Studies; D004232:Diuretics; D005260:Female; D006620:Hip Fractures / Q000209:etiology*; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012307:Risk Factors; D049993:Sodium Chloride Symporter Inhibitors; D013693:Temazepam / Q000009:adverse effects
D001581:Benzothiadiazines; D004232:Diuretics; D011619:Psychotropic Drugs; D049993:Sodium Chloride Symporter Inhibitors; D013693:Temazepam