Bohlken Jens, Jacob Louis, Schaum Peter, Rapp Michael A, Kostev Karel
Praxis für Neurologie und Psychiatrie, Berlin, Germany.
Department of Biology, École Normale Supérieure de Lyon, Lyon, France.
Dementia (London). 2017 Oct;16(7):853-864. doi: 10.1177/1471301215621854. Epub 2015 Dec 23.
The aim was to analyze the risk of hip fracture in German primary care patients with dementia. This study included patients aged 65-90 from 1072 primary care practices who were first diagnosed with dementia between 2010 and 2013. Controls were matched (1:1) to cases for age, sex, and type of health insurance. The primary outcome was the diagnosis of hip fracture during the three-year follow-up period. A total of 53,156 dementia patients and 53,156 controls were included. A total of 5.3% of patients and 0.7% of controls displayed hip fracture after three years. Hip fracture occurred more frequently in dementia subjects living in nursing homes than in those living at home (9.2% versus 4.3%). Dementia, residence in nursing homes, and osteoporosis were risk factors for fracture development. Antidementia, antipsychotic, and antidepressant drugs generally had no significant impact on hip fracture risk when prescribed for less than six months. Dementia increased hip fracture risk in German primary care practices.
目的是分析德国初级保健中痴呆患者髋部骨折的风险。本研究纳入了来自1072家初级保健机构的65至90岁患者，这些患者在2010年至2013年间首次被诊断为痴呆。对照（1:1）在年龄、性别和医疗保险类型方面与病例匹配。主要结局是三年随访期内髋部骨折的诊断。共纳入53156例痴呆患者和53156例对照。三年后，5.3%的患者和0.7%的对照出现髋部骨折。居住在养老院的痴呆患者比居家患者髋部骨折更频繁（9.2%对4.3%）。痴呆、居住在养老院和骨质疏松是骨折发生的危险因素。抗痴呆药、抗精神病药和抗抑郁药在处方使用少于六个月时，一般对髋部骨折风险无显著影响。在德国初级保健中，痴呆增加了髋部骨折风险。
