Cognitive impairment, drug use, and the risk of hip fracture in persons over 75 years old: a community-based prospective study.
Cognitive impairment, drug use, and the risk of hip fracture in persons over 75 years old: a community-based prospective study.
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DOI：
10.1093/oxfordjournals.aje.a009714
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发表时间：
1998-11
影响因子：
5
通讯作者：
Zhenchao Guo;P. Wills;M. Viitanen;J. Fastbom;B. Winblad
中科院分区：
文献类型：
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作者：
Zhenchao Guo;P. Wills;M. Viitanen;J. Fastbom;B. Winblad
作者研究了认知功能和药物使用对髋部骨折发病率的影响，这些人是以社区为基础的瑞典人，其中1608人年龄在1987年10月1日，年龄在75岁，没有髋部骨折。在7123.8人年的随访中，发现134例第一髋部骨折。考克斯比例风险模型被用来估计发生髋部骨折的相对风险，考虑了几个潜在的混杂因素。与无认知损害的受试者相比，轻度损害(简明精神状态检查分数18-23)的相对危险度为2.04(95%可信区间(CI)1.29-3.24)，中-重度损害(简明精神状态检查分数)的相对危险度为2.09(95%可信区间为1.17-3.72)。使用阿片类镇痛剂的受试者(97%服用丙氧酚)的相对危险度为2.01(95%可信区间1.19-3.40)。服用钾补充剂(99%服用氯化钾)与髋部骨折风险的降低有关(相对风险=0.55，95%可信区间0.31-0.98)，而利尿剂没有独立的影响。总而言之，研究结果表明，认知障碍和丙氧酚的使用与髋部骨折风险的增加有关。观察到的氯化钾保护作用值得进一步关注。这项研究的局限性是，对药物使用的评估只在基线上进行。
The authors examined the effects of cognitive function, as assessed by the Mini-Mental State Examination, and drug use on the incidence of hip fracture in a community-based Swedish population of 1,608 subjects who were aged > or = 75 years on October 1, 1987, and who had not had a hip fracture. During the 7,123.8 person-year follow-up, 134 first hip fractures were identified. The Cox proportional hazards model was used to estimate the relative risk of developing hip fracture, taking into account several potential confounders. Compared with those without cognitive impairment, subjects with mild impairment (Mini-Mental State Examination scores 18-23) had a relative risk of 2.04 (95% confidence interval (CI) 1.29-3.24), and subjects with moderate-severe impairment (Mini-Mental State Examination score < 18) had a relative risk of 2.09 (95% CI 1.17-3.72). Subjects using opioid analgesics (97% took propoxyphene) had a relative risk of 2.01 (95% CI 1.19-3.40). Taking potassium supplements (99% took potassium chloride) was related to a reduced risk of hip fracture (relative risk = 0.55, 95% CI 0.31-0.98), while diuretics did not have an independent impact. In summary, the results show that cognitive impairment and use of propoxyphene are associated with increased risk of hip fracture. The observed protection of potassium chloride merits further attention. The limitation of the study was that the assessment of drug use was made only at baseline.