Female nursing home residents at lesser risk of osteoporotic fracturesNew research presented at the IOF World Congress on Osteoporosis in Toronto, Canada suggests female nursing home residents have fewer skeletal fractures and are older when those fractures occur than are women who live at home (conference abstract OC5). The findings come from a study of men and women aged 60 or older who were diagnosed with hip fracture at Geneva University Hospital from 1991 to 2000. Geneva University Hospital diagnoses 95% of all hip fractures occurring in Switzerland.
Presenter Dr. Thierry Chevalley, from the hospital's Department of Rehabilitation and Geriatrics, said the study shows annual rates of hip fracture among Swiss women decreased during the 1990s by 1.3% per year. The trend was concentrated entirely among female nursing home residents, however. Chevalley suggests two factors might explain the lessening fracture risk among nursing home residents. "One is a higher level prescription of calcium and vitamin D and to a lesser extent of anti-osteoporotic drugs," he explained. "And the other is that women in nursing homes get better preventative care regarding risk factors for falls, and that care translates to a small decrease in the risk of hip fracture."
No similar trend was observed with respect to Swiss men, who are generally at lesser risk of osteoporosis and who therefore don't get the same level of preventative care and attention, Chevalley said. "We'd like to extend the period of study to 15 years to see if we can confirm the decrease in hip fracture incidence between sexes and also to see what happens among women living at home over a longer time period."
Care Improvements Decrease Risk
Meanwhile, Danielle Preedy from the National Osteoporosis Society in Bath, UK, has shown that with the appropriate care, elderly women living in nursing homes can reduce their risk of falls and bone fractures by up to 50% (conference abstract P102).
The finding suggests untapped opportunities to limit skeletal fractures among high-risk individuals, Preedy says.
Female patients aged 74 years or more completed a validated assessment questionnaire that scored their overall fracture risk. According to responses pertaining to age, smoking history, body weight, mobility, and other factors, the women were divided into low-, moderate-, and high-risk groups. Low and moderate-risk women were offered general lifestyle advice about nutrition and mobility exercises that could minimize future falls and fractures. High-risk women were offered more substantial prevention resources. These included--in addition to lifestyle advice--the opportunity to attend an osteoporosis clinic, and more direct contact with general practitioners who in turn received additional advice on osteoporosis management.
Preedy and colleagues focused exclusively on 789 high-risk women who completed the osteoporosis clinic and who were available for follow-up one year later. Among this group, the mean number of falls per person decreased by nearly half. Therefore, selective identification of high-risk patients and additional training among caregivers were seen to provide valuable opportunities for fracture prevention, Preedy said. "This was a simple, but effective intervention," she emphasized. "It shows that falls can be better managed in primary care."
Prior fractures produce a nearly four-fold elevation in the risk of subsequent fractures among nursing home patients within a year; the result of a "cascade effect" that increases patient vulnerability. Thus, effective prevention among elderly nursing home patients must take note of prior fractures, in addition to regular weight-bearing exercise, and a healthy diet and lifestyle, Preedy said.
Osteoporosis, in which the bones become porous and break easily, is one of the world's most common and debilitating diseases. The result: pain, loss of movement, inability to perform daily chores, and in many cases, death. One out of three women over 50 will experience osteoporotic fractures, as will one out of five men 1, 2, 3. Unfortunately, screening for people at risk is far from being a standard practice. Osteoporosis can, to a certain extent, be prevented, it can be easily diagnosed and effective treatments are available.
The International Osteoporosis Foundation (IOF) is the only worldwide organization dedicated to the fight against osteoporosis. It brings together scientists, physicians, patient societies and corporate partners. Working with its 172 member societies in 85 locations, and other healthcare-related organizations around the world, IOF encourages awareness and prevention, early detection and improved treatment of osteoporosis.
1 Melton U, Chrischilles EA, Cooper C et al. How many women have osteoporosis? Journal of Bone Mineral Research, 1992; 7:1005-10
2 Kanis JA et al. Long-term risk of osteoporotic fracture in Malmo. Osteoporosis International, 2000; 11:669-674
3. Melton LJ, et al. Bone density and fracture risk in men. JBMR. 1998; 13:No 12:1915
IOF World Congress on Osteoporosis, held every two years, is the only global congress dedicated specifically to all aspects of osteoporosis. Besides the opportunity to learn about the latest science and developments in diagnosis, treatment and the most recent socio-economic studies, participants have the chance to meet and exchange ideas with other physicians from around the world. All aspects of osteoporosis will be covered during the Congress which will comprise lectures by invited speakers presenting cutting edge research in the field, and a large number of oral presentations and poster sessions selected from 720 submitted abstracts. More than 70 Meet the Expert Sessions covering many practical aspects of diagnosis and management of osteoporosis are also on the program.
For more information on osteoporosis and IOF please visit: www.osteofound.org
For further information, please contact:
Paul Spencer Sochaczewski, Head of Communications,
International Osteoporosis Foundation:
Andrew Leopold, Weber Shandwick Worldwide
400-207 Queen's Quay West, Toronto, Tel: +1 416 964 6444
Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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