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Association of proton pump inhibitor use with recurrent falls and risk of fractures in older women: A study of medication use in older fallers

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To examine the association between Proton pump inhibitors (PPIs) use and falls and fractures.

Design

A cross-sectional study.

Setting and participants

400 female patients aged 70 years or older who were consecutively admitted to the Trauma Center Meidling, Vienna, after a fall and who required hospital admission.

Methods

We quantified the strength of the associations between PPI use and falls, and between PPI use and fractures, using a logistic regression.

Results

use of PPIs was significantly associated with risk of recurrent falls (OR 1.92, 95% CI = 1.05–3.50, p = 0.04) as well as with risk of a fracture (OR 2.15, 95% CI 1.10–4.21, p = 0.03).

Conclusions

In conclusion, our results provide further evidence that PPI use may increase risk of falls and fractures in older women and highlight the need for clinicians to reassess the original indication and the need for continuation of PPIs on a regular basis.

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References

  1. Gillespie LD, Robertson MC, Gillespie WJ et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9: CD007146. doi: 10.1002/14651858.CD007146.pub3

  2. Petridou ET, Manti EG, Ntinapogias AG, Negri E, Szczerbinska K. What works better for community-dwelling older people at risk to fall?: a meta-analysis of multifactorial versus physical exercise-alone interventions. J Aging Health 2009;21:713–729. doi: 10.1177/0898264309338298

    Article  PubMed  Google Scholar 

  3. Hartholt KA, Van Lieshout EM, Polinder S, Panneman MJ, Van der Cammen TJ, Patka P. Rapid increase in hospitalizations resulting from fall-related traumatic head injury in older adults in The Netherlands 1986-2008. J Neurotrauma 2011;28:739–744. doi: 10.1089/neu.2010.1488

    Article  PubMed  Google Scholar 

  4. Hartholt KA, van der Velde N, Looman CW et al. Trends in fall-related hospital admissions in older persons in the Netherlands. Arch Intern Med 2010;170:905–911. doi: 10.1001/archinternmed.2010.106

    Article  PubMed  Google Scholar 

  5. Parkkari J, Kannus P, Palvanen M et al. Majority of hip fractures occur as a result of a fall and impact on the greater trochanter of the femur: a prospective controlled hip fracture study with 206 consecutive patients. Calcif Tissue Int 1999;65:183–187

    Article  PubMed  CAS  Google Scholar 

  6. Hayes WC, Myers ER, Morris JN, Gerhart TN, Yett HS, Lipsitz LA. Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcif Tissue Int 1993;52:192–198

    Article  PubMed  CAS  Google Scholar 

  7. Centers for Disease Control adn Prevention. Hip Fractures Among Older Adults (2013) http://www.cdc.gov/homeandrecreationalsafety/falls/adulthipfx.html. Accessed 30-September 2014

  8. Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc 1999;47:40–50

    Article  PubMed  CAS  Google Scholar 

  9. Leipzig RM, Cumming RG, Tinetti ME. Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc 1999;47:30–39

    Article  PubMed  CAS  Google Scholar 

  10. Woolcott JC, Richardson KJ, Wiens MO, Patel B, Marin J, Khan KM, et al; Metaanalysis of the impact of 9 medication classes on falls in elderly persons. Arch Intern Med 2009;169:1952–1960. doi: 10.1001/archinternmed.2009.357

    Article  PubMed  Google Scholar 

  11. Rigler SK, Shireman TI, Cook-Wiens GJ et al. Fracture risk in nursing home residents initiating antipsychotic medications. J Am Geriatr Soc 2013;61:715–722. doi: 10.1111/jgs.12216

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ziere G, Dieleman JP, van der Cammen TJ, Hofman A, Pols HA, Stricker BH. Selective serotonin reuptake inhibiting antidepressants are associated with an increased risk of nonvertebral fractures. J Clin Psychopharmacol 2008;8:411–417. doi: 10.1097/JCP.0b013e31817e0ecb

    Article  Google Scholar 

  13. Xing D, Ma XL, Ma JX, Wang J, Yang Y, Chen Y. Association between use of benzodiazepines and risk of fractures: a meta-analysis. Osteoporos Int 2014;25:105–120. doi: 10.1007/s00198-013-2446-y

    Article  PubMed  CAS  Google Scholar 

  14. Tinetti ME, Han L, Lee DS et al. Antihypertensive medications and serious fall injuries in a nationally representative sample of older adults. JAMA Intern Med 2014;174:588–595. doi: 10.1001/jamainternmed.2013.14764

    Article  PubMed  PubMed Central  Google Scholar 

  15. Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA 2006;296:2947–2953

    Article  PubMed  CAS  Google Scholar 

  16. Yu EW, Bauer SR, Bain PA, Bauer DC. Proton pump inhibitors and risk of fractures: a meta-analysis of 11 international studies. Am J Med 2011;124:519–526. doi: 10.1016/j.amjmed.2011.01.007

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  17. Kwok CS, Yeong JK, Loke YK. Meta-analysis: risk of fractures with acidsuppressing medication. Bone 2011;48:768–776. doi: 10.1016/j.bone.2010.12.015

    Article  PubMed  CAS  Google Scholar 

  18. Chen J, Yuan YC, Leontiadis GI, Howden CW. Recent safety concerns with proton pump inhibitors. J Clin Gastroenterol 2012;46:93–114. doi: 10.1097/MCG.0b013e3182333820

    Article  PubMed  Google Scholar 

  19. Targownik LE, Lix LM, Leung S, Leslie WD. Proton-pump inhibitor use is not associated with osteoporosis or accelerated bone mineral density loss. Gastroenterology 2010;138:896–904. doi: 10.1053/j.gastro.2009.11.014

    Article  PubMed  CAS  Google Scholar 

  20. Gray SL, LaCroix AZ, Larson J et al. Proton pump inhibitor use, hip fracture, and change in bone mineral density in postmenopausal women: results from the Women’s Health Initiative. Arch Intern Med 2010;170:765–771. doi: 10.1001/archinternmed.2010.94

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kuipers MT, Thang HD, Arntzenius AB. Hypomagnesaemia due to use of proton pump inhibitors—a review. Neth J Med 2009;67:169–172

    PubMed  CAS  Google Scholar 

  22. Regolisti G, Cabassi A, Parenti E, Maggiore U, Fiaccadori E. Severe hypomagnesemia during long-term treatment with a proton pump inhibitor. Am J Kidney Dis 2010;56:168–174. doi: 10.1053/j.ajkd.2010.03.013

    Article  PubMed  Google Scholar 

  23. Cundy T, Dissanayake A. Severe hypomagnesaemia in long-term users of protonpump inhibitors. Clin Endocrinol (Oxf) 2008;69:338–341. doi: 10.1111/j.1365-2265.2008.03194.x.

    Article  CAS  Google Scholar 

  24. Lewis JR, Barre D, Zhu K et al. Long-Term Proton Pump Inhibitor Therapy and Falls and Fractures in Elderly Women: A Prospective Cohort Study. J Bone Miner Res Epub 2014/05/16. doi: 10.1002/jbmr.2279

    Google Scholar 

  25. Kellogg. The prevention of falls in later life. A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly. Dan Med Bull 1987;34 Suppl 4:1–24.

    Google Scholar 

  26. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001;49:664–672

    Article  Google Scholar 

  27. Tromp AM, Pluijm SM, Smit JH, Deeg DJ, Bouter LM, Lips P. Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol 2001;54:837–844

    Article  PubMed  CAS  Google Scholar 

  28. WHO Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment. http://www.whocc.no/atcddd/. Accessed 20 August 2014

  29. Corsonello A, Maggio M, Fusco S, Adamo B, Amantea D, Pedone C, et al. Proton pump inhibitors and functional decline in older adults discharged from acute care hospitals. J Am Geriatr Soc 2014;62:1110–1115. doi: 10.1111/jgs.12826

    Article  PubMed  Google Scholar 

  30. Askari M, Eslami S, Scheffer AC, Medlock S, de Rooij SE, van der Velde N, et al. Different risk-increasing drugs in recurrent versus single fallers: are recurrent fallers a distinct population? Drugs Aging 2013;30:845–851. doi: 10.1007/s40266-013-0110-z

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Trauma Hospital Meidling, Vienna, Austria

    H.W. Thaler

  2. Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands

    C.S. Sterke

  3. Aafje nursing homes, Rotterdam, the Netherlands

    C.S. Sterke

  4. Section of Geriatric Medicine, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands

    Tischa J.M. Van Der Cammen

  5. Department of Medicine, Brighton and Sussex Medical School, Brighton, UK

    Tischa J.M. Van Der Cammen

  6. Faculty of Industrial Design Engineering, Department of Industrial Design, Delft University of Technology, Delft, the Netherlands

    Tischa J.M. Van Der Cammen

Authors
  1. H.W. Thaler
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  2. C.S. Sterke
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  3. Tischa J.M. Van Der Cammen
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Corresponding author

Correspondence to Tischa J.M. Van Der Cammen.

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Thaler, H., Sterke, C. & Van Der Cammen, T. Association of proton pump inhibitor use with recurrent falls and risk of fractures in older women: A study of medication use in older fallers. J Nutr Health Aging 20, 77–81 (2016). https://doi.org/10.1007/s12603-016-0679-0

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  • DOI: https://doi.org/10.1007/s12603-016-0679-0

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