5Fragility Fractures & Their Impact on Older People
Section snippets
Definition of osteoporosis and osteoporotic fractures
Osteoporosis is defined as a systemic skeletal disease characterised by a low bone mass and a microarchitecture deterioration of bone tissue, with a subsequent increase in bone fragility and susceptibility to fracture [1]. It behaves as a silent disease. A high percentage of affected people are not aware that they have the condition. Consequently, osteoporosis burden is better assessed by measuring the burden of its clinical outcome, i.e. osteoporotic fractures (also known as ‘fragility
Health consequences of osteoporotic fractures
The consequences of osteoporotic fractures for an individual range from chronic pain, loss of mobility, and loss of independence to institutionalisation and death [10], [11], [12].
Hip is the location of fracture leading to the poorest health outcomes, in part because of the peak incidence of such fractures occurring in populations that are 70–79 years old [10]; therefore, the incidence and subsequent loss of health is considerably higher in developed countries [10]. At 1 year after the hip
Epidemiology of osteoporotic fractures: population trends
Osteoporosis has been estimated to affect 200 million women worldwide, approximately one-tenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and two-thirds of women aged 90 [39]. For a person over 50 years living in a developed country, the lifetime risk of sustaining any fracture in their remaining years of life has been estimated to be approximately 50% for women and 20% for men, and most of these will be related to osteoporosis [40], [41]. Age and female gender
Economic cost of osteoporotic fractures
The economic burden of osteoporosis results both from acute outcomes, such as hospital admission and surgery after an incident fracture, and long-term consequences related to chronic disability and costs of pharmacological and non-pharmacological interventions. Simultaneously, the costs are classified as direct (e.g. treatment of incident fractures, pharmacological prevention, institutionalisation, etc.), indirect, corresponding to the productivity losses of the sufferer and carers, and
Low bone mineral density as a preventable risk factor for fractures
For the last two decades, the operational definition of osteoporosis has been based on BMD values: osteoporosis may be diagnosed in postmenopausal women and in men aged 50 years and older if the BMD measured by dual X-ray absorptiometry (DXA) at lumbar spine, total hip or femoral neck (in certain circumstances, the 33% distal radius may be utilised) is −2.5 SD or less from the mean BMD value in young females (T-score −2.5 or less) [1] (Fig. 3). The young reference values should be obtained by
Conflict of interest statement
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Role of biophysical stimulation in multimodal management of vertebral compression fractures
2023, Computational and Structural Biotechnology JournalClinical practice of Best Practice Nursing Care Standards for Older Adults with Fragility Hip Fracture: A propensity score matched analysis
2021, Applied Nursing ResearchCitation Excerpt :They can occur from mild trauma or even during everyday activities. Common types of fragility fractures include hip fracture, distal radius fracture, proximal humerus fracture, and vertebral compression fracture (Sànchez-Riera & Wilson, 2017). Among these, fragility hip fracture (FHF) comprises approximately 20% of the total number of fragility fractures (Abrahamsen et al., 2009).
Pharmacologic intervention for prevention of fractures in osteopenic and osteoporotic postmenopausal women: Systemic review and meta-analysis
2020, Bone ReportsCitation Excerpt :Fragility fractures commonly cause disabilities and mortality in older adults and are major contributors to medical care costs worldwide (Sanchez-Riera and Wilson, 2017). A majority of such fractures occur in postmenopausal women without osteoporosis diagnoses (Lindsay et al., 2001), yet low bone mineral density (BMD) is recognized as an important preventable risk factor for osteoporotic fractures (Sanchez-Riera and Wilson, 2017). Women who develop osteoporotic vertebral and hip fractures are at substantial risk for additional fractures within 1 year (Johansson et al., 2017).
Recommendations on screening for primary prevention of fragility fractures
2023, CMAJ. Canadian Medical Association JournalSecondary fracture and mortality risk with very high fracture risk osteoporosis and proximal femoral fracture
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