title: Bisphosphonate Use After Hip Fracture in Older Adults: A Nationwide Retrospective Cohort Study.
abstract: OBJECTIVE
  The aim of this study was to investigate the association between bisphosphonate use and the risk of new fracture in a nationwide cohort of individuals with previous hip fractures, with emphasis on individuals above 80 years of age.
  
  
  METHODS
  From a nationwide cohort with hip fracture (2006-2012) (n = 93, 601), each individual prescribed bisphosphonates after hip fracture (n = 5845) was matched with up to three individuals not prescribed bisphosphonates, resulting in a cohort of 21,363 individuals.
  
  
  METHODS
  A new hip fracture.
  
  
  RESULTS
  During a mean follow-up period of 2.98 (range, 0.02-8) years, 4581 fractures occurred in the cohort. Before the initiation of bisphosphonate therapy, individuals later prescribed bisphosphonates had an increased risk of hip fracture (multivariable adjusted odds ratio [OR], 2.63; 95% confidence interval [CI], 2.23-3.24) compared with controls. In the period after bisphosphonate therapy initiation, individuals prescribed bisphosphonates had a lower risk of hip fracture (multivariable adjusted hazard ratio [HR], 0.76; 95% CI, 0.65-0.90) compared with controls. Similar effects were seen after the initiation of bisphosphonates in individuals aged more than 80 years (HR, 0.79; 95% CI, 0.62-0.99). In contrast, the initiation of bisphosphonate therapy did not influence the risk of injurious falls not resulting in fracture (HR, 0.95; 95% CI, 0.86-1.05).
  
  
  CONCLUSIONS
  Bisphosphonate use was associated with a decreased risk of hip fracture in this nationwide cohort of older men and women, with similar risk reductions in individuals older than 80 years.
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatrics, Umeå, Sweden. Electronic address: peter.nordstrom@umu.se.
authors.forename: Peter
authors.initials: P
authors.lastname: Nordström
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatrics, Umeå, Sweden; Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå, Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Toots
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatrics, Umeå, Sweden.
authors.forename: Yngve
authors.initials: Y
authors.lastname: Gustafson
authors.affiliation: Department of Clinical Sciences, Orthopedics, Lund University, Lund, Sweden.
authors.forename: Karl-Göran
authors.initials: KG
authors.lastname: Thorngren
authors.affiliation: Department of Clinical Sciences, Orthopedics, Lund University, Lund, Sweden.
authors.forename: Ami
authors.initials: A
authors.lastname: Hommel
authors.affiliation: Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Nordström
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006620:Hip Fractures / Q000188:drug therapy*; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates
keywords: Hip fractures; bisphosphonates; cohort study; older individuals