Laxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women's Health Initiative
Haring, Bernhard ; Pettinger, Mary B. ; Bea, Jennifer W. ; Wactawski-Wende, Jean ; Carnahan, Ryan M. ; Ockene, Judith K. ; Wyler von Ballmoos, Moritz ; Wallace, Robert B. ; Wassertheil-Smoller, Sylvia
Citations
Student Authors
Faculty Advisor
Academic Program
UMass Chan Affiliations
Document Type
Publication Date
Keywords
Aged
Bone Density
Female
Follow-Up Studies
Fractures, Bone
Humans
Incidence
Laxatives
Middle Aged
Osteoporosis, Postmenopausal
Prospective Studies
*Women's Health
Laxative use
Falls
Fractures
Bone mineral density
Aging
Community Health and Preventive Medicine
Geriatrics
Pharmaceutical Preparations
Preventive Medicine
Women's Health
Subject Area
Embargo Expiration Date
Link to Full Text
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 (>/=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.
Source
Haring B, Pettinger M, Bea JW, Wactawski-Wende J, Carnahan RM, Ockene JK, Wyler von Ballmoos M, Wallace RB, Wassertheil-Smoller S. Laxative use and incident falls, fractures and change in bone mineral density in postmenopausal women: results from the Women's Health Initiative. BMC Geriatr. 2013 May 1;13:38. doi: 10.1186/1471-2318-13-38. Link to article on publisher's site