Osteoporosis and fragility fractures.

摘要

Osteoporosis is an almost universal problem in nursing homes with up to 85% of white women in nursing homes being osteoporotic. Osteoporosis, coupled with falls, is the major risk for fractures in the nursing home. Following a hip fracture, 20% of subjects are dead within 1 year, 30% have a permanent disability, and 40% cannot walk independently. Persons with vertebral fractures have back pain, dysphagia, kyphosis, reduced pulmonary function, and diminished quality of life. They also have nearly a doubling in their age-standardized mortality ratio. The impact in hip fractures is particularly severe in frail persons and those with undernutrition. Intentional weight loss leads to a 2.3 increase in hip fracture in older women. Aggressive treatment of osteoporosis and an intensive falls program can reduce these negative outcomes.