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    Fall and fracture risk in nursing home residents with moderate-to-severe behavioral symptoms of Alzheimer's disease and related dementias initiating antidepressants or antipsychotics

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    Author
    Wei, Y.-J.
    Simoni-Wastila, L.
    Lucas, J.A.
    Date
    2017
    Journal
    Journals of Gerontology - Series A Biological Sciences and Medical Sciences
    Publisher
    Oxford University Press
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://www.doi.org/10.1093/gerona/glw095
    Abstract
    Background: Both antidepressants and antipsychotics are used in older adults with behavioral symptoms of Alzheimer's disease and related dementias. Despite the prevalent use of these agents, little is known about their comparative risks for falls and fractures. Methods: Using 2007-2009 Medicare claims data linked to Minimum Data Set 2.0, we identified new users of antidepressants and antipsychotics among nursing home residents with Alzheimer's disease and related dementias who had moderate-to-severe behavioral symptoms. Separate discrete-time survival models were used to estimate risks of falls, fractures, and a composite of both among antidepressant group versus antipsychotic group. Results: Compared to antipsychotic users, antidepressant users experienced significantly higher risk for fractures (adjusted hazard ratio = 1.35, 95% confidence interval = 1.10-1.66). The overall risk of falls or fractures remained significant in the antidepressant versus antipsychotic group (adjusted hazard ratio = 1.16, 95% confidence interval = 1.02-1.32). Conclusions: Antidepressants are associated with higher fall and fracture risk compared to antipsychotics in the management of older adults with Alzheimer's disease and related dementias who experience moderate-to-severe behavioral symptoms. Clinicians need to assess the ongoing risks/benefits of antidepressants for these symptoms especially in light of the increasingly prevalent use of these agents. Copyright The Author 2016.
    Keyword
    Alzheimer's disease and related dementia
    Antidepressants
    Antipsychotics
    Falls
    Fractures
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85019974754&doi=10.1093%2fgerona%2fglw095&partnerID=40&md5=aaa3dcfae0bd9bc8a6da3060b634d554; http://hdl.handle.net/10713/9968
    ae974a485f413a2113503eed53cd6c53
    10.1093/gerona/glw095
    Scopus Count
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    UMB Open Access Articles 2017

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