This article is more than 5 years old. Information may no longer be current.
Better screening could help prevent fractures for long-term care residents, study finds
Click Here to Manage Email Alerts
A study published recently in the Journal of the American Geriatrics Society has demonstrated that screening strategies vary greatly — from 17% to 98% — in identifying women residing in nursing homes for whom osteoporosis treatment is indicated.
“Osteoporosis in the frail elderly can have devastating consequences, but we have yet to perfect a system for identifying those patients who would benefit most from the treatment,” lead study author Susan Greenspan, MD, professor of medicine at the University of Pittsburgh, stated in a news release.
She and colleagues investigated 202 frail women aged 65 years and older with a mean age of 85 years, residing in 11 long-term care facilities in the Pittsburgh area. They excluded women who received bisphosphonates, according to the release.
Greenspan and her team then screened the women for a history of bone fracture, bone mineral density (BMD) by standard DEXA scanning, the fracture risk assessment tool (FRAX) in conjunction with body mass index (BMI), FRAX in conjunction with femoral neck bone density, and heel ultrasound.
According to the study abstract, treatment eligibility for the patients ranged between 17% for clinical fracture to 98% for FRAX assessment in conjunction with BMI. Vertebral fractures were reportedly found in 47% of patients, with almost three-quarters of them fractures being “silent,” causing no symptoms.
The researchers concluded in the release that a reasonable clinical approach would be to consider treatment for those with clinical fractures of the hip or spine, radiologic evidence for a vertebral fracture, or osteoporosis by BMD classification.
“This is worrisome because many physicians rely on bone density screening, but that approach missed half the women with vertebral fractures who would be candidates for osteoporosis treatment,” Greenspan stated in the release.
“Still, some form of screening for vertebral fractures is appropriate because treatment could prevent more osteoporosis damage and future fractures,” she added.
Reference:
- Greenspan SL, Perera S, Nace D, et al. FRAX or fiction: Determining optimal screening strategies for treatment of osteoporosis in residents in long-term care facilities. J Am Geriatr Soc. 2012. doi: 10.1111/j.1532-5415.2011.03884.x
- Disclosure: The study was funded by the National Institutes of Health and a private family donation.
Follow
OrthoSuperSite.com on Twitter