title: Sedative-hypnotic drugs and the risk of hip fracture.
abstract: A retrospective cohort study was conducted in individuals 65 years of age and older using Medicaid-reimbursed claims to assess the risk of hip fracture in users of two sedative-hypnotic drugs, triazolam and temazepam. Using the triazolam cohort as the referent group, the rate ratio was 0.92 (95% confidence interval, 0.72 to 1.17) for hip fracture with temazepam. Stratifying by age, sex, race, residence, time enrolled in Medicaid, prescription number, combinations of these, and several other potential confounding variables did not materially change the results. Compared with the short-acting benzodiazepine hypnotic temazepam, use of triazolam, an ultra-short-acting benzodiazepine hypnotic, did not decrease the risk of hip fracture. This study did not determine that either drug, compared with no use in an insomniac control group, increases the risk of hip fracture. However, because sedative-hypnotic drugs have been found in other studies to increase the risk of falling and hip fracture, they should be used with caution, especially in the elderly.
authors.affiliation: Office of Epidemiology and Biostatistics, Food and Drug Administration, Rockville, Maryland, USA.
authors.forename: D K
authors.initials: DK
authors.lastname: Wysowski
authors.forename: C
authors.initials: C
authors.lastname: Baum
authors.forename: W J
authors.initials: WJ
authors.lastname: Ferguson
authors.forename: F
authors.initials: F
authors.lastname: Lundin
authors.forename: M J
authors.initials: MJ
authors.lastname: Ng
authors.forename: T
authors.initials: T
authors.lastname: Hammerstrom
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D005431:Florida / Q000453:epidemiology; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects* / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D008824:Michigan / Q000453:epidemiology; D009820:Ohio / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013693:Temazepam / Q000009:adverse effects* / Q000627:therapeutic use; D014229:Triazolam / Q000009:adverse effects* / Q000627:therapeutic use; D014481:United States
chemical_list: D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D014229:Triazolam; D013693:Temazepam