Letter to the Editor| Volume 21, ISSUE 5, P706-707, May 2020

Comment on “Association Between Acetylcholinesterase Inhibitors and Osteoporotic Fractures in Alzheimer's Patients”

      In a recent issue of the Journal of the American Medical Directors Association, Won et al
      • Won D.Y.
      • Byun S.J.
      • Jeong J.S.
      • Shin J.Y.
      Association between acetylcholinesterase inhibitors and osteoporotic fractures in older persons with Alzheimer's disease.
      focused on to the association of acetylcholinesterase inhibitors (AChEIs) with osteoporotic fractures among older adults with Alzheimer's disease (AD). With existing conflicting findings on this association, the current study significantly extended evidence by showing in a huge study sample that subjects on AChEIs were at a small increased risk of osteoporotic fractures. Another important aspect of this study is that dose, duration of treatment, and exposure timing of AChEIs were not associated with a reduced risk of osteoporotic fractures. However, a few points deserve discussion, as the findings may be confounded by some additional factors including delirium, subsyndromal delirium, and selected medications.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of the American Medical Directors Association
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Won D.Y.
        • Byun S.J.
        • Jeong J.S.
        • Shin J.Y.
        Association between acetylcholinesterase inhibitors and osteoporotic fractures in older persons with Alzheimer's disease.
        J Am Med Dir Assoc. 2020 Jan 8; ([Epub ahead of print])
        • American Psychiatric Association
        Diagnostic and Statistical Manual of Mental Disorders.
        5th ed. APA Press, Washington, DC2013
        • Cole M.G.
        • Ciampi A.
        • Belzile E.
        • Dubuc-Sarrasin M.
        Subsyndromal delirium in older people: A systematic review of frequency, risk factors, course and outcomes.
        Int J Geriatr Psychiatry. 2013; 28: 771-780
        • Fick D.M.
        • Agostini J.V.
        • Inouye S.K.
        Delirium superimposed on dementia: A systematic review.
        J Am Geriatr Soc. 2002; 50: 1723-1732
        • Palermo A.
        • D'Onofrio L.
        • Eastell R.
        • et al.
        Oral anti-diabetic drugs and fracture risk, cut to the bone: safe or dangerous? A narrative review.
        Osteoporos Int. 2015; 26: 2073-2089
        • Corrao G.
        • Mazzola P.
        • Monzio Compagnoni M.
        • et al.
        Antihypertensive medications, loop diuretics, and risk of hip fracture in the elderly: A population-based cohort study of 81,617 Italian patients newly treated between 2005 and 2009.
        Drugs Aging. 2015; 32: 927-936
        • Yang Y.
        • Hu X.
        • Zhang Q.
        • Zou R.
        Diabetes mellitus and risk of falls in older adults: A systematic review and meta-analysis.
        Age Ageing. 2016; 45: 761-767
        • Banu Z.
        • Lim K.K.
        • Kwan Y.H.
        • et al.
        Anti-hypertensive medications and injurious falls in an older population of low socioeconomic status: A nested case-control study.
        BMC Geriatr. 2018; 18: 195
        • Wang Z.
        • Li Y.
        • Zhou F.
        • et al.
        Effects of statins on bone mineral density and fracture risk: A PRISMA-compliant systematic review and meta-analysis.
        Medicine (Baltimore). 2016; 95: e3042
        • Cosman F.
        • de Beur S.J.
        • LeBoff M.S.
        • et al.
        National Osteoporosis Foundation. Clinician's guide to prevention and treatment of osteoporosis.
        Osteoporos Int. 2014; 25: 2359-2381