Occasional benzodiazepine use does not induce hip, forearm fractures in older adults

Occasional use of benzodiazepines (BZD), which is compatible with current recommendation, does not increase the risk of the most frequent fall-related fractures in older adults, according to a study.

The authors analysed BZD dispensing (reflecting patterns of use) and the most frequent fall-related fractures (ie, hip and forearm) for 8 years in a representative cohort of the French National Health Insurance Fund of individuals aged ≥50 years (n=106,437).

Joint latent class models were used to simultaneously identify BZD dispensing trajectories and the risk of fractures in the entire cohort and in those aged ≥75 years. Finally, the authors estimated the adjusted hazard ratios (aHRs) between these trajectories and the risk of fractures using a survival model.

Five BZD trajectories have been identified in the entire cohort: nonusers (76.7 percent of the participants), occasional users (15.2 percent), decreasing users (2.6 percent), late increasing users (3.0 percent), and early increasing users (2.4 percent).

The risk of fracture was not increased in both occasional users (aHR, 0.99, 95 percent confidence interval [CI], 0.99–1.00) and decreasing users (aHR, 0.90, 95 percent CI, 0.74–1.08) in comparison with nonusers. However, the risk was significant higher in early increasing users (aHR, 1.86, 95 percent CI, 1.62–2.14) and in late increasing users (aHR, 1.39, 95 percent CI, 1.15–1.60).

In addition, similar trajectories and risk levels were observed in individuals aged >75 years.