PDF(Pubmed)
Abstract：
Patients with Parkinson\'s disease often experience sleep disorders. Hypnotics increase the risk of adverse events, such as injuries due to falls. In this study, we evaluated the association between hypnotics and injuries among older adults with Parkinson\'s disease.
The study used a nested case-control design. The participants were 5009 patients with Parkinson\'s disease aged ≥ 75 years based on claims data between April 2016 and March 2019 without prescription hypnotics 1 year before the study started. Hypnotics prescribed as oral medications included benzodiazepines, non-benzodiazepines, orexin receptor antagonists, and melatonin receptor agonists. The incidences of outcomes, including injuries, fractures, and femoral fractures, were determined. Each case had four matched controls. Conditional logistic regression analyses were performed to calculate the odds ratios and 95% confidence intervals for the number of hypnotics taken per day for each type of hypnotic.
The proportion of participants taking at least one type of hypnotic was 18.6%, with benzodiazepines being the most common. The incidence of injuries, fractures, and femoral fractures was 66.7%, 37.8%, and 10.2%, respectively. Benzodiazepines significantly increased the risk of injuries (odds ratio: 1.12; 95% confidence interval: 1.03-1.22), and melatonin receptor agonists significantly increased the risk of femoral fractures (odds ratio: 2.84; 95% confidence interval: 1.19-6.77).
Benzodiazepines and non-benzodiazepines, which are not recommended according to current guidelines, were the most prevalent among older adults with Parkinson\'s disease. Benzodiazepines significantly increased the risk of injuries, and melatonin receptor agonists significantly increased the risk of femoral fractures.
The study used a nested case-control design. The participants were 5009 patients with Parkinson\'s disease aged ≥ 75 years based on claims data between April 2016 and March 2019 without prescription hypnotics 1 year before the study started. Hypnotics prescribed as oral medications included benzodiazepines, non-benzodiazepines, orexin receptor antagonists, and melatonin receptor agonists. The incidences of outcomes, including injuries, fractures, and femoral fractures, were determined. Each case had four matched controls. Conditional logistic regression analyses were performed to calculate the odds ratios and 95% confidence intervals for the number of hypnotics taken per day for each type of hypnotic.
The proportion of participants taking at least one type of hypnotic was 18.6%, with benzodiazepines being the most common. The incidence of injuries, fractures, and femoral fractures was 66.7%, 37.8%, and 10.2%, respectively. Benzodiazepines significantly increased the risk of injuries (odds ratio: 1.12; 95% confidence interval: 1.03-1.22), and melatonin receptor agonists significantly increased the risk of femoral fractures (odds ratio: 2.84; 95% confidence interval: 1.19-6.77).
Benzodiazepines and non-benzodiazepines, which are not recommended according to current guidelines, were the most prevalent among older adults with Parkinson\'s disease. Benzodiazepines significantly increased the risk of injuries, and melatonin receptor agonists significantly increased the risk of femoral fractures.
摘要：
背景：帕金森病患者常出现睡眠障碍。催眠药会增加不良事件的风险，比如跌倒造成的伤害。在这项研究中,我们评估了患有帕金森病的老年人中催眠药与损伤之间的关联.
方法：本研究采用嵌套病例对照设计。根据2016年4月至2019年3月的索赔数据，参与者为5009名年龄≥75岁的帕金森病患者，在研究开始前1年没有处方催眠药。口服催眠药包括苯二氮卓类药物，非苯二氮卓类药物，食欲素受体拮抗剂，和褪黑激素受体激动剂。结果的发生率，包括受伤,骨折,股骨骨折,决心。每个病例都有四个匹配的对照。进行条件逻辑回归分析，以计算每种类型的催眠药每天服用催眠药数量的比值比和95％置信区间。
结果：服用至少一种催眠药的参与者比例为18.6%，苯二氮卓类药物是最常见的。伤害的发生率，骨折,股骨骨折占66.7%，37.8%,和10.2%，分别。苯二氮卓类药物显著增加受伤风险(比值比:1.12;95%置信区间:1.03-1.22),和褪黑素受体激动剂显著增加股骨骨折的风险(比值比:2.84;95%置信区间:1.19-6.77).
结论：苯二氮卓类药物和非苯二氮卓类药物，根据目前的指导方针，这是不推荐的，在患有帕金森病的老年人中最普遍。苯二氮卓类药物显著增加受伤的风险，褪黑素受体激动剂显著增加股骨骨折的风险.
方法：本研究采用嵌套病例对照设计。根据2016年4月至2019年3月的索赔数据，参与者为5009名年龄≥75岁的帕金森病患者，在研究开始前1年没有处方催眠药。口服催眠药包括苯二氮卓类药物，非苯二氮卓类药物，食欲素受体拮抗剂，和褪黑激素受体激动剂。结果的发生率，包括受伤,骨折,股骨骨折,决心。每个病例都有四个匹配的对照。进行条件逻辑回归分析，以计算每种类型的催眠药每天服用催眠药数量的比值比和95％置信区间。
结果：服用至少一种催眠药的参与者比例为18.6%，苯二氮卓类药物是最常见的。伤害的发生率，骨折,股骨骨折占66.7%，37.8%,和10.2%，分别。苯二氮卓类药物显著增加受伤风险(比值比:1.12;95%置信区间:1.03-1.22),和褪黑素受体激动剂显著增加股骨骨折的风险(比值比:2.84;95%置信区间:1.19-6.77).
结论：苯二氮卓类药物和非苯二氮卓类药物，根据目前的指导方针，这是不推荐的，在患有帕金森病的老年人中最普遍。苯二氮卓类药物显著增加受伤的风险，褪黑素受体激动剂显著增加股骨骨折的风险.
