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Identifying Fracture Risk Requires Wide Net

Osteoporosis less common than fall-related, other bone-related risk factors for fracture in study

TUESDAY, Feb. 12 (HealthDay News) -- Preventing fractures in the elderly population requires screening tools that utilize both bone- and fall-related risk factors to identify individuals at risk for fractures, according to research published in the February issue of the Journal of Bone & Joint Surgery.

Svenhjalmar van Helden, M.D., of the University Hospital Maastricht in Maastricht, the Netherlands, and colleagues analyzed data from 568 patients (mean age 67) who were treated for fracture. Subjects received a bone-mineral density assessment with dual x-ray absorptiometry; assessment of bone-related risk factors for fractures, including personal or maternal history of fractures or low body weight; and assessment of fall-related risk factors, including recent history of falling or impaired vision.

The prevalence of osteoporosis (35 percent) was lower than the prevalence of fall-related risk factors (75 percent) and bone-related risk factors (53 percent) at the time of fracture. Fifty percent of patients had both bone- and fall-related risk factors. As a result, the authors state that most people with a recent clinical fracture don't have osteoporosis, and guidelines focusing on identifying osteoporosis fail to prospectively identify most people with fracture risk.

"Most patients with a recent clinical fracture do not have osteoporosis. Thus, simply ordering a dual x-ray absorptiometry scan to select patients for treatment means that many patients with a high fracture risk will be discharged without further treatment. In these cases, the bone-related risk factors independent of bone mineral density and the fall-related risk factors will persist and will therefore need to be addressed and corrected whenever possible," the authors write.

Several of the study's authors report financial relationships with pharmaceutical companies.

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