Table 2.
Adjusted hazard ratios for new Z-drug prescription and adverse events for people with dementia
| 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) |
Abbreviations: HR hazard ratio, CI confidence interval, GP general practitioner, PY person-years
aAdjusted for all covariates listed in Table 1
bFully adjusted HR remaining statistically significant after controlling the false discovery rate to < 5% (based on 13 outcomes)
cNot adjusted for antiepileptics, antiplatelet drugs, pneumonia vaccine, and anxiety symptoms due to model instability