ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2016
Patterns of selective serotonin reuptake inhibitor use and risk of falls and fractures in community-dwelling elderly people: the Three-City cohort.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Alliance between selective serotonin reuptake inhibitors and fracture risk: an updated systematic review and meta-analysis.European journal of clinical pharmacology · 2020Pooled it
- Placebo-controlled three-armed pilot trial of Escitalopram or Nortriptyline for depressive symptoms in Parkinson's disease (ADepT-PD).Journal of neural transmission (Vienna, Austria : 1996) · 2026Trial
- Effectiveness of Escitalopram and Nortriptyline on Depressive Symptoms in Parkinson's disease: the ADepT-PD RCT pilot.Health technology assessment (Winchester, England) · 2025Trial
- Development of a web platform for predicting fall risk in cardiovascular patients using machine learning.Scientific reports · 2026Article
- Requests for Compensation in Cases Involving Patients' Falls in Healthcare Settings: A Retrospective Analysis.Healthcare (Basel, Switzerland) · 2023Article
- Article
- Bortezomib in first-line therapy is associated with falls in older adults with multiple myeloma.Journal of geriatric oncology · 2021Article
- Chronic Polypharmacy with Increasing Drug Burden Index Exacerbates Frailty and Impairs Physical Function, with Effects Attenuated by Deprescribing, in Aged Mice.The journals of gerontology. Series A, Biological sciences and medical sciences · 2021Article
- Safety of antidepressants in a primary care cohort of adults with obesity and depression.PloS one · 2021Article
- Individual Antidepressants and the Risk of Fractures in Older Adults: A New User Active Comparator Study.Clinical epidemiology · 2020Article
- Sex-specific depressive symptoms as markers of pre-Alzheimer dementia: findings from the Three-City cohort study.Translational psychiatry · 2019Article
- FOCUS trial: results, potentialities and limits.Annals of translational medicine · 2019Article
- Antidepressants and the risk of traumatic brain injury in the elderly: differences between individual agents.Clinical epidemiology · 2019Article
- Factors associated with falls in older adults with cancer: a validated model from the Cancer and Aging Research Group.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In this population-based elderly cohort, participants using selective serotonin reuptake inhibitor (SSRI) antidepressants have an increased risk of falls and fractures notably when the treatment was continued over 4 years. Among the various SSRI types, citalopram only was at significant risk for falls and fluoxetine for fractures.
introductionIncreased risk of falls and fractures has been reported in elderly users of SSRIs. However, biases were insufficiently addressed notably temporality between exposure and outcome and confounding by residual depression. Our objective was to examine the associations between SSRIs and fall or fracture incidence focusing on their chronic use and different types of SSRIs.
methodsThe population-based cohort included participants aged 65 years and above, who had not fallen before inclusion (n = 6599) or were free of recent fracture (n = 6823) and were followed up twice over 4 years. New fall and fracture events were self-reported and defined as at least two falls and one fracture, respectively, during the previous 2 years. SSRI users were compared with those taking no antidepressants. Hazard ratios (HRs) were estimated using Cox models with delayed entry and adjusted for many confounders including residual depressive symptoms.
resultsIncidence of falls was 19.3 % over 4 years and that of fractures 9.5 %. After multi-adjustment, SSRI intake was significantly associated with a higher risk of falls (HR, 95 % CI = 1.58, 1.23-2.03) and fractures (HR, 95 % CI = 1.61, 1.16-2.24). The risks were significantly increased by 80 % in those continuing the treatment over 4 years. Citalopram intake only was at significant risk for falls and fluoxetine for fractures.
conclusionsIn this large community-dwelling elderly sample, SSRI users were at higher risk of falls and fractures. This association was not due to reverse causality or residual depressive symptoms. Different SSRI drugs may have specific adverse effects on falls and fractures.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.