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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
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BMC Medicine

ISSN: 1741-7015

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