Alzheimer’s patients at no greater risk for hip fracture with long-term PPI use
The use of proton pump inhibitors over a long period did not increase the risk for hip fracture in patients with Alzheimer’s disease, according to new research published in Alimentary Pharmacology & Therapeutics.
Sanna Torvinen-Kiiskinen, PhD, of Kuopio Research Centre of Geriatric Care at the University of Eastern Finland, and colleagues wrote that an association between proton pump inhibitor (PPI) use and risk for fractures remains unclear due to contradictory study findings, and their research is the first to look at the potential risk in patients with Alzheimer’s.
“It has been supposed that PPI use lead to bone loss and fractures by reducing calcium absorption,” they wrote. “However, some studies have reported that PPI use has no effect on bone structure. Other mechanisms suggested are myopathy or vitamin B12 deficiency leading to injurious falls and fractures.”
Using nationwide data on patients that included information on medication use and Alzheimer’s diagnosis, Torvinen-Kiiskinen and colleagues identified 4,818 community-dwelling patients with Alzheimer’s disease (mean age = 84.1). The investigators matched four controls with each case at the date of hip fracture (n = 19,235, mean age = 84 years).
Almost half of the cases (n = 2,321, 48%) and controls (n = 9,066, 47%) had used PPIs within 10 years of the beginning of the study. The investigators found an association between current PPI use and increased hip fracture risk (adjusted OR =1.12; 95% CI, 1.03–1.22) but not past use. Additionally, the risk was only increased for short-term use of less than a year (aOR = 1.23; 95% CI, 1.1–1.37). The researchers did not find that the risk for fracture increased for patients who used PPIs for longer than a year.
“There was no risk increase for long-term or cumulative PPI use and thus, our findings do not support previous assumptions that long-term PPI use would be associated with an increased risk of hip fracture,” the investigators wrote. “At least in terms of hip fracture, long-term use of PPI can be considered among persons with Alzheimer’s disease if the treatment is necessary.” – by Alex Young
Disclosures: Torvinen-Kiiskinen reports receiving personal research grants from Finnish Cultural Foundation and Olvi Foundation. Please see the full study for the other authors’ relevant financial disclosures.