Hypnotics and injuries among older adults with Parkinson's disease: a nested case-control design

• Published in: BMC geriatrics 2023-05, Vol.23 (1), p.259-259, Article 259
• Main Authors: Fujita, Takako, Babazono, Akira, Li, Yunfei, Jamal, Aziz, Kim, Sung-A
• Format: Article
• Language: English
• Subjects: Aged; Aged patients; Agonists; Anemia; Antiparkinsonian agents; Benzodiazepines; Benzodiazepines - adverse effects; Care and treatment; Case-Control Studies; Comorbidity; Complications and side effects; Dosage and administration; Falls (Accidents); Femoral Fractures; Femur; Fractures; Geriatrics; Humans; Hypnotics; Hypnotics and Sedatives; Injuries; Insomnia; Long term health care; Melatonin; Melatonin receptor agonists; Movement disorders; Neurodegenerative diseases; Older people; Orexin receptor antagonists; Orexins; Osteoporosis; Parkinson Disease - drug therapy; Parkinson's disease; Prescription drugs; Prevention; Receptors, Melatonin; Regression analysis; Risk factors; Sedatives; Sleep disorders
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-023-03944-9

Patients with Parkinson's disease often experience sleep disorders. Hypnotics increase the risk of adverse events, such as injuries due to falls. In this study, we evaluated the association between hypnotics and injuries among older adults with Parkinson's disease. The study used a nested case-control design. The participants were 5009 patients with Parkinson's disease aged ≥ 75 years based on claims data between April 2016 and March 2019 without prescription hypnotics 1 year before the study started. Hypnotics prescribed as oral medications included benzodiazepines, non-benzodiazepines, orexin receptor antagonists, and melatonin receptor agonists. The incidences of outcomes, including injuries, fractures, and femoral fractures, were determined. Each case had four matched controls. Conditional logistic regression analyses were performed to calculate the odds ratios and 95% confidence intervals for the number of hypnotics taken per day for each type of hypnotic. The proportion of participants taking at least one type of hypnotic was 18.6%, with benzodiazepines being the most common. The incidence of injuries, fractures, and femoral fractures was 66.7%, 37.8%, and 10.2%, respectively. Benzodiazepines significantly increased the risk of injuries (odds ratio: 1.12; 95% confidence interval: 1.03-1.22), and melatonin receptor agonists significantly increased the risk of femoral fractures (odds ratio: 2.84; 95% confidence interval: 1.19-6.77). Benzodiazepines and non-benzodiazepines, which are not recommended according to current guidelines, were the most prevalent among older adults with Parkinson's disease. Benzodiazepines significantly increased the risk of injuries, and melatonin receptor agonists significantly increased the risk of femoral fractures.