Anticholinergic use is associated with lower mortality but not increased hip fracture risk in Parkinson's disease patients: a retrospective cohort study.

Background: It is unclear whether antiparkinsonism anticholinergics (AAs) increase hip fracture (HFx) risk in Parkinson's disease (PD) patients. This study examined associations between AAs, HFx and mortality in PD using Taiwan's National Health Insurance Database.
Methods: Newly diagnosed PD patients ≥ 50yrs were categorized by AAs exposure: PD with AAs (≥ 90 days, n = 16,921), PD without AAs (never-exposed, n = 55,940), and demographically matched non-PD controls (n = 291,444). Competing risk of death was considered in Fine & Gray models analyzing HFx. Mortality was compared using Cox regression models.
Results: Both PD groups were associated with higher HFx risk compared to non-PD controls (adjusted hazard ratio [HR] = 1.51 for PD with AAs; 1.53 without). No significant difference in HFx risk was observed between PD groups with and without AAs exposure. Both groups were associated with increased mortality compared to non-PD (adjusted HR = 2.24 with AAs; 2.44 without AAs). Among PD patients, those with AAs exposure were associated with lower mortality compared to those without AAs (adjusted HR = 0.93).
Conclusions: PD was associated with increased HFx and mortality compared to non-PD, regardless of AAs exposure. AAs use was not associated with increased HFx risk and was associated with lower mortality. AAs use was not associated with increased fracture risk and was associated with lower mortality in PD, however further studies are needed to clarify these associations.
Competing Interests: Declarations Ethics approval and consent to participate This study was reviewed and approved by the Ethics Committee of the Institutional Review Board (IRB) of E-Da Hospital, under the reference number IRB EMRP108-061. The committee provided ethical approval for the research protocol, ensuring that the study complies with the ethical standards for research involving human participants. This approval encompasses all aspects of the study, affirming our commitment to conducting research ethically and responsibly. The requirement for participant consent was deemed unnecessary by the Ethics Committee of the Institutional Review Board of E-Da Hospital due to the following reasons: the data for this study was sourced from the Taiwan National Health Insurance Database, which contains de-identified or anonymized data. This ensures the privacy and confidentiality of individual patients. According to the regulations and laws governing data privacy and protection in Taiwan, research utilizing such de-identified data does not necessitate direct informed consent from the participants. Consent for publication Not applicable. Competing interests The authors declare no competing interests.
(© 2024. The Author(s).)