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Care of older people

Long-term diuretic use may reduce fracture risk in people with Alzheimer’s disease

Using data from 10,416 community-dwelling people with Alzheimer’s disease, researchers found that thiazide use was associated with a 17% reduced odds of low-energy fracture compared with non use.

Use of thiazide diuretics for three years or more may reduce the risk of low-energy fracture (LEF) in people with Alzheimer’s disease (AD), study results published in Osteoporosis International have suggested (16 April 2019)[1].

The researchers used data from a national Finnish database on 10,416 community-dwelling people with AD who experienced LEF and 5,578 with hip fracture, matched to with three controls without fracture.

Current thiazide use was associated with a 17% reduced odds of LEF compared with non use. There was no association between LEF and short-term use of thiazides. However, use for three years or more was associated with a 23% reduced odds of LEF and a 32% reduced odds of hip fracture.

LEF is usually associated with falls — of which people with AD are at increased risk — which the researchers said made the results “somewhat surprising”. But they suggested that thiazides could affect fracture risk by reducing calcium excretion, leading to increased bone mineral density.

“This finding may have implications for the choice of antihypertensive medications in this vulnerable patient group with an increased background risk for falls and fractures due to dementia disorder,” they concluded.

Citation: Clinical Pharmacist DOI: 10.1211/CP.2019.20206526

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