7%) 1,808 (6.9%)    50 to 69 years 1,061 (15.7%) 4,239 (16.1%)    ≥70 years 5,250 (77.6%) 20,294 (77.0%)   Mean age in years 75.7 75.3   Number of females 4,929 (72.9%) 19,138 (72.7%)   Drug use before the index date  TCAs 256 (3.8%) 591 (2.2%) 1.75

(1.51–2.04)  SSRIs 315 (4.7%) 582 (2.2%) 2.20 (1.91–2.54) selleck chemicals  Anti-psychoticsa 412 (6.1%) 921 (3.5%) 1.79 (1.58–2.02)  Anti-convulsantsa 242 (3.6%) 431 (1.6%) 2.23 (1.90–2.61)  Benzodiazepinesb 967 (14.3%) 2,751 (10.4%) 1.44 (1.33–1.56)  Oral glucocorticosteroidsa 366 (5.4%) 918 (3.5%) 1.59 (1.40–1.80)  Thiazide diureticsa 146 (2.2%) 557 (2.1%) 1.01 (0.84–1.21)  Opiatesa 253 (3.7%) 455 (1.7%) 2.24 (1.92–2.63)  Anti-Parkinson drugsa 397 (5.9%) 833 (3.2%) 1.94 (1.71–2.19)  ≥2 NSAID prescriptionsa 929 (13.7%) 2,584

find more (9.8%) 1.46 (1.35–1.59) Hospitalisation before the index date  Cardiovascular disease 359 (5.3%) 1,289 (4.9%) 1.10 (0.98–1.25)  Cerebrovascular disease 296 (4.4%) 565 (2.1%) 2.12 (1.84–2.45)  Malignant neoplasms 341 (5.0%) 1,021 (3.9%) 1.54 (1.37–1.74) TCAs tricyclic anti-depressants, SSRIs selective serotonin re-uptake inhibitors, GCs glucocorticosteroids aWithin the 6 months before the index date bWithin the 3 months before the index date Table 2 shows that compared with controls, cases were significantly more likely to have used a benzodiazepine in the previous 3 months and/or an anti-depressant, an anti-psychotic, anti-convulsant, oral glucocorticoid, opiate or drug for Parkinson’s disease within the previous 6 months. In addition, cases were significantly more likely than controls to have a history of cerebrovascular disease or malignant neoplasm. Table 3 provides crude and adjusted risk estimates for hip/femur fracture associated with anti-depressant use according to recency of use, and the results of selleck products analyses amongst current users stratified by sex and age.

Compared with individuals acetylcholine who had never used the anti-depressant in question, the risk of hip/femur fracture increased with current use of SSRIs (crude OR 2.88 [95% CI 2.40–3.46]) and TCAs (crude OR 2.22 [95% CI 1.84–2.68]). After adjustment for other variables associated with fracture risk, the ORs remained significantly increased (ORadj 2.35 [95% CI 1.94–2.84] for SSRIs and 1.76 [95% CI 1.45–2.15] for TCAs). Under the assumption that the risk of hip fracture amongst users of SSRIs/TCAs is similar in the period 1991–2002 and 2003, we estimated that the population attributable risk of hip fracture is 1.1% for current users of TCAs and 4.4% for current users of SSRIs. For SSRIs, there was some effect modification by sex (ORadj 2.50 [95% CI 2.03–3.08] for females and 1.72 [95% CI 1.08–2.74] for males) and age (ORadj 2.00 [95% CI 1.21–3.29] for SSRI users aged 18–69 years and 2.39 [95% CI 1.94–2.94] for SSRI users aged ≥70 years).