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June 27, 1990

Benzodiazepines and Hip Fracture-Reply

Author Affiliations

Vanderbilt University School of Medicine Nashville, Tenn

Vanderbilt University School of Medicine Nashville, Tenn

JAMA. 1990;263(24):3261. doi:10.1001/jama.1990.03440240044014

In Reply. —  Mr Jacobs and Ms Das raise six questions concerning our study. (1) Is the point prevalence of current long-half-life benzodiazepine use in the case subjects different from that of the entire elderly population in Saskatchewan? (2) Does a direct comparison between long- and short—half-life benzodiazepine users show a difference in hip fracture risk? (3) Does use of diazepam for convulsions result in confounding? (4) Should other fall-related injuries have been included as outcomes? (5) Do nonsignificant differences in confounder prevalence for sampled cases that would have been significant in a larger sample indicate inadequate confounder control? (6) Can we rule out any spurious association, particularly with regard to mental impairment?

  1. One of the strengths of this study is that control subjects were sampled randomly from the entire elderly Saskatchewan population of persons without hip fractures, with stratification by demographic characteristics associated with both benzodiazepine use and