Strong painkillers increase the risk of hip fracture among persons with Alzheimer’s disease

People using strong painkillers, opioids, have twice the risk of hip fracture compared to non-opioid users, a new study from the University of Eastern Finland shows. The risk was highest in the first two months of opioid use. The results were published in the PAIN journal.

The risk of hip fracture increased with increasing opioid strength. Use of weak opioids, such as codeine and tramadol, was not associated with the risk of hip fracture. However, moderately strong opioids, such as buprenorphine, were associated with a two-fold risk, and strong opioids, such as oxycodone and fentanyl, were associated with almost a three-fold risk, compared with non-use. Buprenorphine and fentanyl were almost solely used as patches in this study.

Opioids are used for the treatment of severe pain in cases where other painkillers fail to produce a sufficient response. Opioids impact on the central nervous system and for this reason, opioid use may cause attentional impairment or drowsiness. Opioids are known to increase the risk of falls which, in turn, may lead to hip fracture in older people.

The study was based on the nationwide register-based MEDALZ study conducted at the University of Eastern Finland. For this study, 23,100 community-dwelling persons diagnosed with Alzheimer’s disease in Finland during 2010-2011 were included. From this sample, new opioid users were identified and matched with opioid non-users.

For further information, please contact:

Sirpa Hartikainen, Professor, School of Pharmacy, University of Eastern Finland, sirpa.hartikainen(at)uef.fi

Research article:

Taipale H, Hamina A, Karttunen N, Koponen M, Tanskanen A, Tiihonen J, Hartikainen S, Tolppanen AM. Incident opioid use and risk of hip fracture among persons with Alzheimer’s disease, a nationwide matched cohort study. PAIN 2018. Published online Oct 12, 2018. DOI: 10.1097/j.pain.0000000000001412

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The University of Eastern Finland, UEF, is one of the largest universities in Finland. The activities of the UEF underscore multidisciplinarity, and the university is especially strong in research related to forests and the environment, health and well-being, and new technologies and materials. The UEF offers teaching in more than 100 major subjects. In addition to the high standard of teaching, the university offers its students a modern study environment, which is under constant development. The university comprises four faculties: the Philosophical Faculty, the Faculty of Science and Forestry, the Faculty of Health Sciences, and the Faculty of Social Sciences and Business Studies. The university’s campuses are located in the heart of beautiful eastern Finland in Joensuu, Kuopio and Savonlinna. The UEF is home to approximately 15 000 students and nearly 2 800 members of staff.

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