G5 Artikkeliväitöskirja
The Use of Nervous System Drugs and the Risk of Fractures in Old Adults
Tekijät: Nurminen Janne
Kustantaja: Turun yliopisto
Kustannuspaikka: Turku
Julkaisuvuosi: 2014
ISBN: 978-951-29-5732-3
Verkko-osoite: http://urn.fi/URN:ISBN:978-951-29-5733-0
Tiivistelmä
THE USE OF NERVOUS SYSTEM DRUGS AND THE RISK OF FRACTURES IN
OLD ADULTS
The department of General Practice, Institute of Clinical Medicine, Faculty of Medicine,
University of Turku, Turku, Finland. Annales Universitatis Turkuensis, Medica – Odontologica
Series D 1114, 2014, Turku, Finland.
The use of nervous system drugs is common among adults aged 65 years and older. The use of these drugs is most frequent among adults living in long-term care institutions. Literature on adverse effects of nervous system drugs is rich, and indicates that these medications are associated with the risk of fractures. However, studies concerning concomitant use of nervous system drugs and fractures are rare.
This study concluded that the concomitant use of nervous system drugs was very common among patients living in five long-term care wards of Pori City Hospital (n=154). Every third patient used at least three nervous system drugs concomitantly, and the corresponding percentage was 53 when medications taken when needed were also taken into account. Indications of inappropriate drug use were found when patients' medications, cognitive and physical abilities, and diagnoses were compared to evaluate the appropriateness of prescribing practices.
The material for fracture studies was obtained from the longitudinal and population-based Lieto Study comprising 1,177 participants 65 years of age and older. The data on medication use and fractures was used to analyze the associations between nervous system drugs and fractures. The concomitant use of two or more benzodiazepines or two or more antipsychotics was associated
with an increased risk of fractures in men. Furthermore, the use of an opioid with a
benzodiazepine or an antipsychotic increased the risk of fractures in men. These associations were not detected in women. The sample for the benzodiazepine withdrawal study consisted of 89 participants 55 years of age and older participating in the Satauni Study. The study lasted six months. The participants received psychological support while the benzodiazepine dose was gradually lowered over a
one month time period. The participants were frequently tested for handgrip strength and balance. The study resulted in the finding that the handgrip strength of women who had withdrawn improved significantly in comparison to non-withdrawers. The associations were weaker for men. During the six–month follow-up period, no significant change in balance test results associated with benzodiazepine withdrawal was detected. Fractures often lead to serious consequences in late life; therefore, fracture prevention should be a top priority in senior health care policies. The role of concomitant use of nervous system drugs should be addressed in fracture prevention programs.
THE USE OF NERVOUS SYSTEM DRUGS AND THE RISK OF FRACTURES IN
OLD ADULTS
The department of General Practice, Institute of Clinical Medicine, Faculty of Medicine,
University of Turku, Turku, Finland. Annales Universitatis Turkuensis, Medica – Odontologica
Series D 1114, 2014, Turku, Finland.
The use of nervous system drugs is common among adults aged 65 years and older. The use of these drugs is most frequent among adults living in long-term care institutions. Literature on adverse effects of nervous system drugs is rich, and indicates that these medications are associated with the risk of fractures. However, studies concerning concomitant use of nervous system drugs and fractures are rare.
This study concluded that the concomitant use of nervous system drugs was very common among patients living in five long-term care wards of Pori City Hospital (n=154). Every third patient used at least three nervous system drugs concomitantly, and the corresponding percentage was 53 when medications taken when needed were also taken into account. Indications of inappropriate drug use were found when patients' medications, cognitive and physical abilities, and diagnoses were compared to evaluate the appropriateness of prescribing practices.
The material for fracture studies was obtained from the longitudinal and population-based Lieto Study comprising 1,177 participants 65 years of age and older. The data on medication use and fractures was used to analyze the associations between nervous system drugs and fractures. The concomitant use of two or more benzodiazepines or two or more antipsychotics was associated
with an increased risk of fractures in men. Furthermore, the use of an opioid with a
benzodiazepine or an antipsychotic increased the risk of fractures in men. These associations were not detected in women. The sample for the benzodiazepine withdrawal study consisted of 89 participants 55 years of age and older participating in the Satauni Study. The study lasted six months. The participants received psychological support while the benzodiazepine dose was gradually lowered over a
one month time period. The participants were frequently tested for handgrip strength and balance. The study resulted in the finding that the handgrip strength of women who had withdrawn improved significantly in comparison to non-withdrawers. The associations were weaker for men. During the six–month follow-up period, no significant change in balance test results associated with benzodiazepine withdrawal was detected. Fractures often lead to serious consequences in late life; therefore, fracture prevention should be a top priority in senior health care policies. The role of concomitant use of nervous system drugs should be addressed in fracture prevention programs.
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