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Jantzi M, Maher AC, Ioannidis G, Hirdes JP, Giangregorio LM, Papaioannou A. Individuals with neurological diseases are at increased risk of fractures within 180 days of admission to long-term care in Ontario. Age Ageing 2015; 44:252-7. [PMID: 25398885 DOI: 10.1093/ageing/afu156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Individuals residing in long-term care (LTC) are more likely to have a fragility fracture than community-dwelling seniors. The purpose of this study was to determine whether the presence of neurological diseases was associated with an increased risk of fracture within 180 days of admission to LTC. METHODS This retrospective cohort study used data collected in the LTC setting using the Resident Assessment Instrument (RAI) 2.0 during the period from 2006 to 2011 (N=42,089). Multivariable logistic regression analyses were conducted to determine the associations between the presence of neurological conditions and incident fractures, with and without adjustment for clinical variables. RESULTS The incident fracture rate for all LTC residents was 2.6% (N=1,094). Neurological condition group size ranged from n=21,015 for Alzheimer's disease or related dementias (ADRD) to n=21 for muscular dystrophy (MD). The incidence of fracture among residents with specific neurological diseases was as follows: ADRD, 3.2% (n=672), MD, 4.8% (n=1), Parkinson's disease, 2.5% (n=57), stroke, 2.3% (n=166), epilepsy, 2.5% (n=38), Huntington's disease, 1.4% (n=1), multiple sclerosis, 0.3% (n=1) and traumatic brain injury, 3.8% (n=11); among the comparison group with no neurological conditions, the fracture rate was 2.0% (n=366). The neurological diseases that were associated with a significantly greater odds of having an incident fracture in the first 180 days of LTC admission were as follows: ADRD (1.3; 95% CI: 1.1-1.5), epilepsy (1.5; 95% CI: 1.0-2.1) and traumatic brain injury (2.7; 95% CI: 1.4-5.0). CONCLUSION LTC residents with ADRD, epilepsy and traumatic brain injury are at a higher risk for sustaining an incident fracture in the first 180 days of admission and should be considered for fracture prevention strategies.
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Affiliation(s)
- Micaela Jantzi
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Amy C Maher
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - George Ioannidis
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - John P Hirdes
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Lora M Giangregorio
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
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Rolland Y, de Souto Barreto P, Abellan Van Kan G, Annweiler C, Beauchet O, Bischoff-Ferrari H, Berrut G, Blain H, Bonnefoy M, Cesari M, Duque G, Ferry M, Guerin O, Hanon O, Lesourd B, Morley J, Raynaud-Simon A, Ruault G, Souberbielle JC, Vellas B. Vitamin D supplementation in older adults: searching for specific guidelines in nursing homes. J Nutr Health Aging 2013; 17:402-12. [PMID: 23538667 DOI: 10.1007/s12603-013-0007-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The prevalence of vitamin D insufficiency is very high in the nursing home (NH) population. Paradoxically, vitamin D insufficiency is rarely treated despite of strong clinical evidence and recommendations for supplementation. This review aims at reporting the current knowledge of vitamin D supplementation in NH and proposing recommendations adapted to the specificities of this institutional setting. DESIGN Current literature on vitamin D supplementation for NH residents was narratively presented and discussed by the French Group of Geriatrics and Nutrition. RESULT Vitamin D supplementation is a safe and well-tolerated treatment. Most residents in NH have vitamin D insufficiency, and would benefit from vitamin D supplement. However, only few residents are actually treated. Current specific and personalized protocols for vitamin D supplementation may not be practical for use in NH settings (e.g., assessment of serum vitamin D concentrations before and after supplementation). Therefore, our group proposes a model of intervention based on the systematic supplementation of vitamin D (1,000 IU/day) since the patient's admission to the NH and throughout his/her stay without the need of a preliminary evaluation of the baseline levels. Calcium should be prescribed only in case of poor dietary calcium intake. CONCLUSION A population-based rather than individual-based approach may probably improve the management of vitamin D insufficiency in the older population living in NH, without increasing the risks of adverse health problems. The clinical relevance and cost effectiveness of this proposal should be assessed under NH real-world conditions to establish its feasibility.
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Affiliation(s)
- Y Rolland
- Department of Geriatric Medicine, CHU Toulouse, Institute of aging, F-31059 Toulouse, France.
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Morley JE. Frailty, Falls, and Fractures. J Am Med Dir Assoc 2013; 14:149-51. [DOI: 10.1016/j.jamda.2012.12.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 12/18/2012] [Indexed: 12/24/2022]
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Hommel E, Ghazi A, White H. Minimal trauma fractures: lifting the specter of misconduct by identifying risk factors and planning for prevention. J Am Med Dir Assoc 2011; 13:180-6. [PMID: 21683662 DOI: 10.1016/j.jamda.2011.04.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 04/28/2011] [Accepted: 04/29/2011] [Indexed: 12/13/2022]
Abstract
Minimal trauma fractures are an unfortunate, yet not uncommon, event for frail elderly individuals in long term care facilities. These fractures result in significant morbidity including pain and loss of function along with significantly increased mortality. Further concern exists for the medico-legal issues raised after a minimal trauma fracture is discovered. The controversy at hand is whether such fractures are primarily the result of inadequate, careless, or abusive care practices. We build a case to the contrary. Although the data regarding this condition are limited, there exists a reasonable evidence base to identify an at-risk patient population. We present a representative case and subsequent literature review of minimal trauma fractures to illustrate the condition, including risk factors, mode of presentation, and patient outcomes. No direct research has been conducted on the pathophysiology of these fractures. Extrapolating from other similar conditions and likely associated comorbid illnesses, we explore possible physiologic explanations for their occurrence. Again, no direct investigation into prevention or treatment of minimal trauma fractures has been published. Instead, we consider a variety of pharmacologic and nonpharmacologic interventions that may modify the risk for minimal trauma fractures considering the previously identified risk factors and probable pathophysiologic changes leading to fracture development. We propose that reducing minimal trauma fractures in the frail elderly nursing home population will require careful staff education, close attention to identify at-risk patients, and implementation of select interventions aimed at preventing such fractures.
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Affiliation(s)
- Erin Hommel
- Department of Internal Medicine, Division of Geriatrics, University of Texas Medical Branch, Galveston, TX, USA.
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Parikh S, Brookhart MA, Stedman M, Avorn J, Mogun H, Solomon DH. Correlations of nursing home characteristics with prescription of osteoporosis medications. Bone 2011; 48:1164-8. [PMID: 21320653 PMCID: PMC3096758 DOI: 10.1016/j.bone.2011.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 01/18/2011] [Accepted: 02/06/2011] [Indexed: 11/25/2022]
Abstract
BACKGROUND Osteoporosis is highly prevalent in the nursing home (NH) populations but medications that increase bone mineral density are used infrequently. Prior research finds few patient characteristics predict treatment. NH characteristics have been associated with prescription of some medications. We examined associations of NH-level characteristics with osteoporosis treatment in elderly patients admitted to a NH after a fracture. METHOD We conducted a cohort study of patients with hip, wrist and humeral fractures admitted to a NH in NJ. They were followed for 12 months from 1999 to 2004. Possible NH-level predictors of receiving osteoporosis treatment were assessed in mixed multivariable models to account for clustering within individual NHs. RESULTS Of the 2838 post-fracture patients identified from 180 NHs, 156 (5.5%) were prescribed an osteoporosis medication. There was wide variation in treatment between individual NHs (0-40%), which was substantially reduced after adjusting for patient case mix. Several patient characteristics did associate with osteoporosis treatment-female gender (odds ratio (OR) 2.56, 95% confidence interval (CI) 1.42, 4.61), younger age per year (OR 0.98, 95%CI 0.96, 0.99), white race (OR 2.37, 95%CI 1.23, 4.56) and prior history of fracture (OR 4.41, 95%CI 1.04, 18.73). However no NH characteristics significantly associate with treatment (profit status, NH chain member, occupancy rate, and bed size). CONCLUSION NH characteristics did not predict pharmacological treatment of osteoporosis. Further studies of osteoporosis prescribing in NHs need to consider other types of variables as possible correlates of prescribing.
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Affiliation(s)
- Seema Parikh
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Womens’ Hospital and Harvard Medical School, Suite 3030 1640 Tremont St, Boston, MA
- Division of Gerontology, Lowry Medical Office Building, Suite 1B, Beth Israel Deaconess Medical Center 110 Francis St, Boston MA 02215
- Division of Rheumatology, Brigham and Womens’ Hospital, 75 Francis St Boston, MA 02115
| | - M. Alan Brookhart
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Womens’ Hospital and Harvard Medical School, Suite 3030 1640 Tremont St, Boston, MA
| | - Margaret Stedman
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Womens’ Hospital and Harvard Medical School, Suite 3030 1640 Tremont St, Boston, MA
| | - Jerry Avorn
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Womens’ Hospital and Harvard Medical School, Suite 3030 1640 Tremont St, Boston, MA
| | - Helen Mogun
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Womens’ Hospital and Harvard Medical School, Suite 3030 1640 Tremont St, Boston, MA
| | - Daniel H Solomon
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Womens’ Hospital and Harvard Medical School, Suite 3030 1640 Tremont St, Boston, MA
- Aged Care Services, Caulfield General Medical Center, 260 Kooyong Road, Caulfield, Victoria, Australia 3162
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All-cause mortality rates of hip fractures treated in the VHA: do they differ from Medicare facilities? J Am Med Dir Assoc 2010; 11:116-9. [PMID: 20142066 DOI: 10.1016/j.jamda.2009.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 07/30/2009] [Indexed: 11/23/2022]
Abstract
PURPOSE To estimate the 1-year all-cause mortality rates for hip fracture (HFx) patients hospitalized at Veterans Health Administration (VHA) facilities and compare with previous published mortality rates for veterans treated in Medicare facilities. METHODS In total, 7 years of VHA discharge data on HFxs for 12,539 patients age 65 and older were combined with national death registry data. We performed a 1-year survival analysis using the Cox proportional hazard method. RESULTS The adjusted rates for veterans treated in the VHA (30 days=9.3%, 90 days=17.5%, 180 days=23.3%, 365 days=29.8%) were similar to veterans treated in Medicare facilities (30 days=8.9%, 90 days=15.6%, 180 days=21.8%, 365 days=29.9%). For veterans treated for a HFx in Medicare facilities, the average length of stay was 7 days and 49% were discharged to a nursing home. Veterans treated in the VHA had an average length of stay of 14 days and only 35% were discharged to a nursing home. CONCLUSIONS Our study suggests no difference in HFx-adjusted mortality rates between the VHA and Medicare facilities. Given the institutional factor differences between Medicare and the VHA, future study and comparison of health outcomes for nursing home HFx patients and related costs between these two health care programs may contribute to the on-going health care reform debate.
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Álvares LM, Lima RDC, Silva RAD. Ocorrência de quedas em idosos residentes em instituições de longa permanência em Pelotas, Rio Grande do Sul, Brasil. CAD SAUDE PUBLICA 2010; 26:31-40. [DOI: 10.1590/s0102-311x2010000100004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Accepted: 09/08/2009] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi descrever a ocorrência de quedas e fatores associados em idosos residentes em instituições de longa permanência para idosos em Pelotas, Rio Grande do Sul, Brasil. Foi utilizado um questionário estruturado com perguntas sobre características demográficas, morbidade, uso de psicotrópicos e ocorrência de quedas. Em dezembro de 2006, foram visitadas todas as 21 instituições de longa permanência para idosos registradas na cidade. Dentre elas, 19 consentiram em participar do estudo. Foram identificados 377 idosos, mas 96 não tinham condições de responder o questionário e 38 foram recusas. Dos 243 idosos incluídos no estudo, a maioria era mulheres (72,8%) e tinha, em média, 77,7 (DP = 8,9) anos. Cerca de um terço dos idosos (32,5%) sofreu pelo menos uma queda no último ano. A ocorrência de quedas foi duas vezes maior nas mulheres, nos idosos com reumatismo ou doença da coluna e naqueles que utilizavam medicação psicotrópica. Pretende-se que as informações obtidas possibilitem discussões sobre a saúde dos idosos residentes em instituições de longa permanência.
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Giangregorio LM, Jantzi M, Papaioannou A, Hirdes J, Maxwell CJ, Poss JW. Osteoporosis management among residents living in long-term care. Osteoporos Int 2009; 20:1471-8. [PMID: 19209376 PMCID: PMC5101051 DOI: 10.1007/s00198-009-0837-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Accepted: 11/24/2008] [Indexed: 01/06/2023]
Abstract
UNLABELLED Fractures in long-term care (LTC) residents have substantial economic and human costs. Osteoporosis management in residents with fractures or osteoporosis is low, and certain subgroups are less likely to receive therapy, e.g., those with >5 comorbidities, dementia, and wheelchair use. Many LTC residents who are at risk of fracture are not receiving optimal osteoporosis management. INTRODUCTION The objective of this study was to describe the prevalence and predictors of osteoporosis management among LTC residents with osteoporosis or fractures. METHODS In a retrospective study, LTC residents of 17 facilities in Ontario and Manitoba, Canada were investigated. The participants were 65+ years old with osteoporosis, history of hip fracture, or recent fracture. Comprehensive assessments were conducted by trained nurse assessors between June 2005 and June 2006 using a standardized instrument, known as the Resident Assessment Instrument 2.0. RESULTS Among residents (n = 525) with osteoporosis or fractures, 177 (34%) had had a recent fall. Bisphosphonate use was reported in 199 (38%) residents, calcitonin use in six (1%), and raloxifene use in six (1%). Calcium and vitamin D supplementation were reported in 140 (27%) residents. Fifty-four (10.3%) residents were on a bisphosphonate but were not taking vitamin D or multivitamin. Variables negatively associated with osteoporosis therapy [OR (95% CI)]: six or more comorbidities [0.46 (0.28-0.77), p = 0.028], wheelchair use [0.62 (0.40-0.95), p = 0.003], cognitive impairment [0.71 (0.55-0.92), p = 0.009], depression [0.54 (0.34-0.87), p = 0.01], swallowing difficulties [0.99 (0.988-0.999), p = 0.034] or Manitoba residence [0.47 (0.28-0.78), p = 0.004]. Prescription of 10+ medications was positively associated with therapy [3.34 (2.32-4.84), p < 0.001]. CONCLUSION Osteoporosis management is not optimal among residents at risk of future fracture. Identifying at-risk subgroups of residents that are not receiving therapy may facilitate closing the osteoporosis care gap.
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Affiliation(s)
- L M Giangregorio
- Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada.
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Morley JE. Phronesis and the Medical Director. J Am Med Dir Assoc 2009; 10:149-52. [DOI: 10.1016/j.jamda.2008.10.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Accepted: 10/24/2008] [Indexed: 12/15/2022]
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Morley JE, Anker SD, Evans WJ. Cachexia and aging: an update based on the Fourth International Cachexia Meeting. J Nutr Health Aging 2009; 13:47-55. [PMID: 19151908 DOI: 10.1007/s12603-009-0009-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This manuscript highlights the new developments in the pathophysiology of anorexia, cachexia and sarcopenia, based on presentations given at the Fourth International Cachexia Meeting. It stresses the importance of these conditions in older persons.
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Affiliation(s)
- J E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine and GRECC, VA Medical Center, St Louis, MO 63104, USA.
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Morley JE. Rapid Cycles (Continuous Quality Improvement), an Essential Part of the Medical Director's Role. J Am Med Dir Assoc 2008; 9:535-8. [DOI: 10.1016/j.jamda.2008.08.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Accepted: 08/07/2008] [Indexed: 10/21/2022]
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Messinger-Rapport BJ, Thomas DR, Gammack JK, Morley JE. Clinical Update on Nursing Home Medicine: 2008. J Am Med Dir Assoc 2008; 9:460-75. [DOI: 10.1016/j.jamda.2008.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Accepted: 07/07/2008] [Indexed: 12/11/2022]
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Morris J, Hawthorne KM, Hotze T, Abrams SA, Hirschi KD. Nutritional impact of elevated calcium transport activity in carrots. Proc Natl Acad Sci U S A 2008; 105:1431-5. [PMID: 18202180 PMCID: PMC2234161 DOI: 10.1073/pnas.0709005105] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2007] [Indexed: 11/18/2022] Open
Abstract
Nutrition recommendations worldwide emphasize ingestion of plant-based diets rather than diets that rely primarily on animal products. However, this plant-based diet could limit the intake of essential nutrients such as calcium. Osteoporosis is one of the world's most prevalent nutritional disorders, and inadequate dietary calcium is a known contributor to the pathophysiology of this condition. Previously, we have modified carrots to express increased levels of a plant calcium transporter (sCAX1), and these plants contain approximately 2-fold-higher calcium content in the edible portions of the carrots. However, it was unproven whether this change would increase the total amount of bioavailable calcium. In randomized trials, we labeled these modified carrots with isotopic calcium and fed them to mice and humans to assess calcium bioavailability. In mice feeding regimes (n = 120), we measured (45)Ca incorporation into bones and determined that mice required twice the serving size of control carrots to obtain the calcium found in sCAX1 carrots. We used a dual-stable isotope method with (42)Ca-labeled carrots and i.v. (46)Ca to determine the absorption of calcium from these carrots in humans. In a cross-over study of 15 male and 15 female adults, we found that when people were fed sCAX1 and control carrots, total calcium absorption per 100 g of carrots was 41% +/- 2% higher in sCAX1 carrots. Both the mice and human feeding studies demonstrate increased calcium absorption from sCAX1-expressing carrots compared with controls. These results demonstrate an alternative means of fortifying vegetables with bioavailable calcium.
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Affiliation(s)
- Jay Morris
- *Vegetable and Fruit Improvement Center, Texas A&M University, College Station, TX 77845; and
- U.S. Department of Agriculture/Agriculture Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030
| | - Keli M. Hawthorne
- U.S. Department of Agriculture/Agriculture Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030
| | - Tim Hotze
- U.S. Department of Agriculture/Agriculture Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030
| | - Steven A. Abrams
- U.S. Department of Agriculture/Agriculture Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030
| | - Kendal D. Hirschi
- *Vegetable and Fruit Improvement Center, Texas A&M University, College Station, TX 77845; and
- U.S. Department of Agriculture/Agriculture Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030
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Morin S, Rahme E, Behlouli H, Tenenhouse A, Goltzman D, Pilote L. Effectiveness of antiresorptive agents in the prevention of recurrent hip fractures. Osteoporos Int 2007; 18:1625-32. [PMID: 17634854 DOI: 10.1007/s00198-007-0421-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Accepted: 06/13/2007] [Indexed: 02/07/2023]
Abstract
UNLABELLED Hip fracture is associated with recurrent fractures and increased mortality. The results of our retrospective cohort study support the use of antiresorptive agents to prevent recurrent hip fractures in this population. INTRODUCTION Hip fracture, the most serious consequence of osteoporosis, is associated with recurrent fractures and increased mortality. Antiresorptive therapy has proven efficacy in the prevention of fractures after vertebral fractures. It is unknown if it can prevent recurrent fractures after a hip fracture. METHODS We designed a population based, retrospective cohort study, using administrative databases and identified patients hospitalized for a hip fracture between 1996 and 2002. The exposure was defined as being dispensed a prescription for an antiresorptive agent at any time following discharge. Multivariate Cox regression models were used to estimate the hazard ratio of recurrent hip fracture. Subgroup and propensity score analyses were performed. RESULTS A total of 20,644 patients were identified; 6,779 filled a prescription for antiresorptive agents. There were 992 recurrent hip fractures. Patients exposed to antiresorptives had a 26% reduction in the rate of recurrent fractures (adjusted hazard ratio 0.74; 95% CI, 0.64-0.86) compared to patients who were not. All subgroups experienced a reduction in recurrent fracture, except the very elderly. Propensity score analyses were consistent with the main analysis. CONCLUSIONS Antiresorptive therapy reduces the risk of recurrent hip fractures in elderly patients. These results provide evidence that this therapy should be considered for secondary prevention of hip fractures.
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Affiliation(s)
- S Morin
- Division of Internal Medicine, McGill University Health Center (MUHC), 1650 Cedar Ave, Room B2-118, Montreal, QC, H3G 1A4, Canada.
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