Proton pump inhibitor use and risk of hip fractures among community‐dwelling persons with Alzheimer's disease—a nested case‐control study

• Published in: Alimentary pharmacology & therapeutics 2018-04, Vol.47 (8), p.1135-1142
• Main Authors: Torvinen‐Kiiskinen, S., Tolppanen, A.‐M., Koponen, M., Tanskanen, A., Tiihonen, J., Hartikainen, S., Taipale, H.
• Format: Article
• Language: English
• Subjects: Alzheimer's disease; Fractures; Hip; Hip joint; Medicin och hälsovetenskap; Neurodegenerative diseases; Older people; Proton pump inhibitors; Protons
• ISSN: 0269-2813; 1365-2036; 1365-2036
• DOI: 10.1111/apt.14589

Summary Background Hip fractures are a major health concern among older persons with Alzheimer's disease, who usually use many concomitant drugs for several diseases. Evidence of the association between proton pump inhibitor use and risk of hip fracture is contradictory. Aim To investigate whether the long‐term use of proton pump inhibitor is associated with risk of hip fractures among community‐dwelling persons with Alzheimer's disease. Methods In this nested case‐control study, the nationwide MEDALZ data were utilised. Community‐dwelling persons with Alzheimer's disease who encountered incident hip fracture (N = 4818; mean age 84.1) were included as cases. Four controls were matched for each case at the date of hip fracture (N = 19 235; mean age 84.0). The association between hip fracture and duration of current PPI use (ongoing use during 0‐30 days before the index date), and cumulative duration of use during 10 years before was investigated with conditional logistic regression. Results Long‐term or cumulative proton pump inhibitor use was not associated with an increased risk of hip fracture. Current proton pump inhibitor use was associated with an increased risk of hip fracture (adjusted OR 1.12, 95% CI 1.03‐1.22). The risk was increased in short‐term current use (