Year: 2008
Type: article
Study design: Observational Study
Abstract: An important, but not well characterized, component of Alzheimer's Disease (AD) is the risk of injuries, especially those leading to hospitalization and surgery. Falls and related fractures are known to be a significant problem with serious consequences in the elderly. The additional risk conferred by AD on fracture occurrence has not been widely studied. To examine the association between fractures and AD. Historical cohort analysis of medical and pharmacy data for over 20 million Americans from January 1, 2000 to March 31, 2006. Persons with a diagnosis and/or medication for AD were identified and followed retrospectively for 12 months prior to their initial AD claim (index date) through 12 months after. A non-AD comparison cohort was matched based on age, sex, and geographic region and followed over same time period. Bone fractures were identified based on diagnosis codes in the medical claims. Logistic regression estimated the fracture risk for those with AD as compared to those without AD controlling for overall disease burden (Charlson comorbidity score), presence of osteoporosis, and presence of narcotic analgesics, antidepressants, sedatives, or hypnotic medication in the pre-index period. A total of 5,396 subjects with AD and 5,396 non-AD subjects were identified. Overall, 38.3% were male and the average (SD) age was 76.9 (10.2) years. A total of 955 (17.7%) subjects in the AD group had at least one fracture, compared to 428 (7.9%) in the non-AD cohort (p < 0.001). In both groups, the most common fracture type was hip (29.7% for the AD group and 17.7% for the non-AD). The second most common fracture type was vertebral (18.7% for the AD group and 15.0% for the non-AD). The adjusted odds ratio for the presence of a fracture was 1.9 (95% CI: 1.6 to 2.1) for persons with AD relative to those without the condition, after controlling for comorbid conditions and patient characteristics. Hip fractures, an event associated with significant morbidity, was the most common fracture experienced by AD patients. Persons with AD have almost a 2 fold higher risk of experiencing a fracture than those without AD.
Source: Alzheimer s & Dementia
Institutions: University of Arizona, Carelon Research (United States)
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1979965666