Laxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women's Health Initiative

Persistent Link:
http://hdl.handle.net/10150/610030
Title:
Laxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women's Health Initiative
Author:
Haring, Bernhard; Pettinger, Mary; Bea, Jennifer; Wactawski-Wende, Jean; Carnahan, Ryan; Ockene, Judith; Wyler, von Ballmoos; Wallace, Robert; Wassertheil-Smoller, Sylvia
Affiliation:
Department of Internal Medicine I, Comprehensive Heart Failure Center, University of Würzburg, Oberdürrbacher Strasse 6, Würzburg, 97080, Germany; Fred Hutchinson Cancer Research Center, Seattle, Washington, USA; Arizona Cancer Center, University of Arizona, Tucson, Arizona, USA; Department of Social and Preventive Medicine, University at Buffalo, SUNY School of Public Health and Health Professions, Buffalo, NY, USA; Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA; Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA; Department of Surgery & Division of Cardiothoracic Surgery, Froedtert Memorial Hospital & Medical College of Wisconsin, Milwaukee, WI, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
Issue Date:
2013
Publisher:
BioMed Central
Citation:
Haring et al. BMC Geriatrics 2013, 13:38 http://www.biomedcentral.com/1471-2318/13/38
Journal:
BMC Geriatrics
Rights:
© 2013 Haring et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
BACKGROUND:Laxatives are among the most widely used over-the-counter medications in the United States but studies examining their potential hazardous side effects are sparse. Associations between laxative use and risk for fractures and change in bone mineral density BMD] have not previously been investigated.METHODS:This prospective analysis included 161,808 postmenopausal women (8907 users and 151,497 nonusers of laxatives) enrolled in the WHI Observational Study and Clinical Trials. Women were recruited from October 1, 1993, to December 31, 1998, at 40 clinical centers in the United States and were eligible if they were 50 to 79 years old and were postmenopausal at the time of enrollment. Medication inventories were obtained during in-person interviews at baseline and at the 3-year follow-up visit on everyone. Data on self-reported falls (greater than or equal to]2), fractures (hip and total fractures) were used. BMD was determined at baseline and year 3 at 3 of the 40 clinical centers of the WHI.RESULTS:Age-adjusted rates of hip fractures and total fractures, but not for falls were similar between laxative users and non-users regardless of duration of laxative use. The multivariate-adjusted hazard ratios for any laxative use were 1.06 (95% confidence interval CI], 1.03-1.10) for falls, 1.02 (95% CI, 0.85-1.22) for hip fractures and 1.01 (95% CI, 0.96-1.07) for total fractures. The BMD levels did not statistically differ between laxative users and nonusers at any skeletal site after 3-years intake.CONCLUSION:These findings support a modest association between laxative use and increase in the risk of falls but not for fractures. Its use did not decrease bone mineral density levels in postmenopausal women. Maintaining physical functioning, and providing adequate treatment of comorbidities that predispose individuals for falls should be considered as first measures to avoid potential negative consequences associated with laxative use.
EISSN:
1471-2318
DOI:
10.1186/1471-2318-13-38
Keywords:
Laxative use; Falls; Fractures; Bone mineral density; Aging
Version:
Final published version
Additional Links:
http://www.biomedcentral.com/1471-2318/13/38

Full metadata record

DC FieldValue Language
dc.contributor.authorHaring, Bernharden
dc.contributor.authorPettinger, Maryen
dc.contributor.authorBea, Jenniferen
dc.contributor.authorWactawski-Wende, Jeanen
dc.contributor.authorCarnahan, Ryanen
dc.contributor.authorOckene, Judithen
dc.contributor.authorWyler, von Ballmoosen
dc.contributor.authorWallace, Roberten
dc.contributor.authorWassertheil-Smoller, Sylviaen
dc.date.accessioned2016-05-20T08:56:56Z-
dc.date.available2016-05-20T08:56:56Z-
dc.date.issued2013en
dc.identifier.citationHaring et al. BMC Geriatrics 2013, 13:38 http://www.biomedcentral.com/1471-2318/13/38en
dc.identifier.doi10.1186/1471-2318-13-38en
dc.identifier.urihttp://hdl.handle.net/10150/610030-
dc.description.abstractBACKGROUND:Laxatives are among the most widely used over-the-counter medications in the United States but studies examining their potential hazardous side effects are sparse. Associations between laxative use and risk for fractures and change in bone mineral density BMD] have not previously been investigated.METHODS:This prospective analysis included 161,808 postmenopausal women (8907 users and 151,497 nonusers of laxatives) enrolled in the WHI Observational Study and Clinical Trials. Women were recruited from October 1, 1993, to December 31, 1998, at 40 clinical centers in the United States and were eligible if they were 50 to 79 years old and were postmenopausal at the time of enrollment. Medication inventories were obtained during in-person interviews at baseline and at the 3-year follow-up visit on everyone. Data on self-reported falls (greater than or equal to]2), fractures (hip and total fractures) were used. BMD was determined at baseline and year 3 at 3 of the 40 clinical centers of the WHI.RESULTS:Age-adjusted rates of hip fractures and total fractures, but not for falls were similar between laxative users and non-users regardless of duration of laxative use. The multivariate-adjusted hazard ratios for any laxative use were 1.06 (95% confidence interval CI], 1.03-1.10) for falls, 1.02 (95% CI, 0.85-1.22) for hip fractures and 1.01 (95% CI, 0.96-1.07) for total fractures. The BMD levels did not statistically differ between laxative users and nonusers at any skeletal site after 3-years intake.CONCLUSION:These findings support a modest association between laxative use and increase in the risk of falls but not for fractures. Its use did not decrease bone mineral density levels in postmenopausal women. Maintaining physical functioning, and providing adequate treatment of comorbidities that predispose individuals for falls should be considered as first measures to avoid potential negative consequences associated with laxative use.en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.biomedcentral.com/1471-2318/13/38en
dc.rights© 2013 Haring et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)en
dc.subjectLaxative useen
dc.subjectFallsen
dc.subjectFracturesen
dc.subjectBone mineral densityen
dc.subjectAgingen
dc.titleLaxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women's Health Initiativeen
dc.typeArticleen
dc.identifier.eissn1471-2318en
dc.contributor.departmentDepartment of Internal Medicine I, Comprehensive Heart Failure Center, University of Würzburg, Oberdürrbacher Strasse 6, Würzburg, 97080, Germanyen
dc.contributor.departmentFred Hutchinson Cancer Research Center, Seattle, Washington, USAen
dc.contributor.departmentArizona Cancer Center, University of Arizona, Tucson, Arizona, USAen
dc.contributor.departmentDepartment of Social and Preventive Medicine, University at Buffalo, SUNY School of Public Health and Health Professions, Buffalo, NY, USAen
dc.contributor.departmentDepartment of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USAen
dc.contributor.departmentDivision of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USAen
dc.contributor.departmentDepartment of Surgery & Division of Cardiothoracic Surgery, Froedtert Memorial Hospital & Medical College of Wisconsin, Milwaukee, WI, USAen
dc.contributor.departmentDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USAen
dc.identifier.journalBMC Geriatricsen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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