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Table 2 Adjusted hazard ratios for new Z-drug prescription and adverse events for people with dementia

From: Adverse effects of Z-drugs for sleep disturbance in people living with dementia: a population-based cohort study

Outcome   Comparator
Z-drug (n = 3532) Sleep disturbance, no sedative-hypnotic (n = 1833) No Z-drug, proximal GP consultation (n = 10,214) Benzodiazepine (n = 5172)
Fracture
 Incidence rate per 100PY (events) 11.4 (164) 7.6 (130) 8.4 (269) 12.5 (223)
 Age, sex-adjusted HR (95% CI) NA 1.39 (1.08–1.78) 1.40 (1.14–1.70) 0.93 (0.76–1.14)
 Fully adjusted HR (95% CI)a NA 1.32 (0.99–1.75) 1.34 (1.08–1.67)b 0.99 (0.80–1.23)
Hip fracture
 Incidence rate per 100PY (events) 5.7 (84) 3.4 (60) 3.5 (115) 5.1 (94)
 Age, sex-adjusted HR (95% CI) NA 1.53 (1.07–2.18) 1.64 (1.23–2.19) 1.11 (0.82–1.49)
 Fully adjusted HR (95% CI)a NA 1.38 (0.92–2.06) 1.59 (1.15–2.19)b 1.10 (0.87–1.65)
Forearm/wrist/hand fracture
 Incidence rate per 100PY (events) 2.0 (29) 1.1 (20) 1.5 (48) 2.5 (46)
 Age, sex-adjusted HR (95% CI) NA 1.80 (0.95–3.41) 1.35 (0.85–2.14) 0.81 (0.51–1.28)
 Fully adjusted HR (95% CI)a NA 1.44 (0.60–3.47) 1.33 (0.77–2.31) 1.00 (0.59–1.70)
Fall
 Incidence rate per 100PY (events) 37.1 (473) 27.3 (384) 25.8 (767) 35.8 (585)
 Age, sex-adjusted HR (95% CI) NA 1.12 (0.97–1.29) 1.52 (1.36–1.71) 1.06 (0.94–1.20)
 Fully adjusted HR (95% CI)a NA 1.02 (0.87–1.21) 1.43 (1.26–1.62)b 1.08 (0.95–1.22)
Mortality
 Incidence rate per 100PY (events) 28.4 (436) 16.7 (301) 24.1 (799) 39.0 (736)
 Age, sex-adjusted HR (95% CI) NA 1.51 (1.29–1.77) 1.20 (1.06–1.34) 0.72 (0.64–0.81)
 Fully adjusted HR (95% CI)a NA 1.38 (1.14–1.66)b 1.08 (0.94–1.23) 0.73 (0.64–0.83)b
Acute bacterial infection
 Incidence rate per 100PY (events) 47.8 (416) 43.6 (220) 40.6 (1325) 57.8 (371)
 Age, sex-adjusted HR (95% CI) NA 1.13 (0.94–1.37) 1.24 (1.09–1.42) 1.01 (0.86–1.18)
 Fully adjusted HR (95% CI)a NA 1.02 (0.82–1.27) 1.13 (0.98–1.31) 0.92 (0.78–1.10)
Ischaemic stroke/transient ischaemic attack
 Incidence rate per 100PY (events) 6.2 (93) 4.4 (77) 5.5 (178) 6.0 (110)
 Age, sex-adjusted HR (95% CI) NA 1.32 (0.95–1.83) 1.20 (0.94–1.54) 1.03 (0.78–1.36)
 Fully adjusted HR (95% CI)a NA 1.35 (0.90–2.04) 1.14 (0.86–1.50) 1.05 (0.78–1.43)
Venous thromboembolism
 Incidence rate per 100PY (events) 1.5 (22) 1.3 (21) 1.4 (43) 2.5 (47)
 Age, sex-adjusted HR (95% CI) NA 1.64 (0.97–2.79) 1.14 (0.74–1.76) 0.79 (0.50–1.25)
 Fully adjusted HR (95% CI)a NA 1.65 (0.74–3.69)c 1.12 (0.67–1.85) 0.82 (0.50–1.34)
  1. Abbreviations: HR hazard ratio, CI confidence interval, GP general practitioner, PY person-years
  2. aAdjusted for all covariates listed in Table 1
  3. bFully adjusted HR remaining statistically significant after controlling the false discovery rate to < 5% (based on 13 outcomes)
  4. cNot adjusted for antiepileptics, antiplatelet drugs, pneumonia vaccine, and anxiety symptoms due to model instability