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Effect of Tamoxifen on Bone Fractures in Older Nursing Home Residents
Author(s) -
Breuer Brenda,
Wallenstein Sylvan,
Anderson Richard
Publication year - 1998
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1998.tb02750.x
Subject(s) - medicine , confidence interval , hip fracture , odds ratio , activities of daily living , tamoxifen , minimum data set , osteoporosis , physical therapy , nursing homes , breast cancer , cancer , nursing
OBJECTIVES: To evaluate the association between tamoxifen (TAM) treatment and rate of bone fractures in older, nursing home residents. PARTICIPANTS: A total of 93,031 women, aged 65 years and older, whose data were part of the 1993 New York State MDS and for whom there was documentation of treatment with at least one medication. SETTING: New York State long‐term care facilities. DESIGN: Cross‐sectional study via secondary analysis of 1385 matched sets of residents. Each set included one resident who was receiving TAM treatment and up to four residents who were not. MEASUREMENTS: Measurements included age, ethnicity, TAM treatment, hormone replacement therapy, vision impairment, any bone fractures, and, specifically, hip fractures. RESULTS: During the 1.5‐year period for which bone fractures are documented in the 1993 MDS, the fracture rates were: 7.62% in women not treated with TAM, 3.20% in women receiving 10 mg TAM daily, and 6.73% in women receiving 20 mg TAM daily. The odds ratio (OR) for bone fractures among women receiving 20 mg TAM daily compared with nontreated women was 0.916 (95% confidence interval (CI): 0.720–1.164; P =.472), and was 0.312 (95% CI: 0.112–0.865; P =.025) for those receiving 10 mg daily. The rates of hip fracture were 4.98%, 2.40%, and 4.57% for controls and women receiving 10 mg and 20 mg TAM daily, respectively. Whereas the hip fracture rate for women receiving 20 mg daily was statistically similar to that of the controls (OR =.963; 95% CI: 0.718–1.291; P =.800), the difference between the controls and those receiving 10 mg daily approached significance (OR: 0.313; 95% CI: 0.096–1.018; P =.054). CONCLUSION: Although standard treatment of 20 mg TAM daily offers no apparent protection against bone fracture in older nursing home residents, a daily 10 mg dose seems to be protective. J Am Geriatr Soc 46:968–972, 1998 .