Longitudinal associations between medication use and risk of vertebral deformity (VD) is unknown. Therefore, we aimed to assess whether medication use is associated with incident VD in older adults.
Methods A population-based cohort study of older adults without prevalent VD at baseline followed for 10.7 years. Incidence of VD was defined as reduction in anterior height of ≥20% relative to posterior height using morphometric X-ray absorptiometry (MXA) of T4-L4 at any of 3 follow-up visits over 10.7 years, using dual emission X-ray absorptiometry (DXA) scans. Log binomial regression analysis was used to assess the association between medication use at baseline and incident VD over 10.7 years; data was inverse probability weighted to adjust for dropouts.
Results In older adults (n=586, age 51-81 years, 42% male), incidence of VD over 10.7 years was 40%. Reduced risk of incident VD was observed with the use of statins (RR 0.73, 95% CI 0.52, 1.03), thiazide diuretics (RR 0.58, 95% CI 0.34, 1.01) and antidepressants (RR 0.54, 95% CI 0.31, 0.97), after adjustment for age, sex, BMI, BMD, calcium and vitamin D supplementation, and use of the other two medications. There was a dose-response relationship between the number of medications used among these three classes and incident VD (RR 0.39, 95% CI 0.18, 0.87 for ≥2 and 0.66, 95% CI 0.49, 0.89 for 1 vs. no medication use).
Conclusions Use of statins, thiazide diuretics and antidepressants may be protective against incident vertebral deformities among older people. Concurrent use of these drugs may have additive benefits.