Summary
In a study of 2005 institutionalized older people, use of oral bisphosphonates was associated with a 27% reduction in risk
of death compared to non-users after adjusting for potential confounders.
Introduction
This study investigated whether reductions in mortality reported in a trial of intravenous zoledronate after hip fracture
could be seen in older people taking oral bisphosphonates.
Methods
Two thousand and five institutionalized older people (mean age 85.7 years) were assessed at baseline and followed up for hip
fracture and death for at least 5 years. Cox proportional hazards regression was used to estimate effects of bisphosphonates
on risk of death.
Results
At baseline, 78 subjects were taking oral bisphosphonates. Over 5 years of follow-up, 1,596 participants (80%) died. Use of
bisphosphonates was associated with a 27% reduction in risk of death compared to non-users after adjusting for age, gender,
type of institution, immobility, number of medications, weight, cognitive function, co-morbidities, and hip fracture incidence
during the follow-up period (hazard ratio 0.73; 95% CI, 0.56 to 0.94; P = 0.02).
Conclusion
Oral bisphosphonates are associated with a reduction in the risk of death in the elderly. The mechanism of effect requires
further investigation.
Keywords Aged care facility – Elderly – Hip fracture – Mortality – Osteoporosis
Funding National Health and Medical Research Council of Australia, Osteoporosis Australia, and Arthritis Australia