Previous Diagnosis Of Osteoporosis Research Articles

Effective Risk Assessment for Distal Radius Fractures: A Rigorous Multivariable Regression Analysis, Using a Novel 8-Item Modified Frailty Index.

Introduction Distal radius fractures (DRFs) are among the most common orthopaedic injuries. The prevalence of DRFs is increasing across all age groups but remains the second most common fracture in the elderly. The modified frailty index (MFI) often predicts morbidity and mortality in orthopaedic injuries. This study aims to determine the predictive value of MFI on complication rates following DRF and the patient length of stay and discharge outcomes. Methods We utilized our MFI to perform a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database. Results In a total of 22,313 patients, the average age was 46 ± 16. An increase in MFI led to an increase in the odds ratio of readmission and reoperation ( p < 0.001). MFI predicted complications, doubling the rate as the score increased from 1 to 2 ( p < 0.001). An MFI of 2 also led to a delayed hospital stay of 5 days ( p < 0.001), as well as an increase in the odds of patients not being sent home at discharge ( p < 0.001). Finally, life-threatening complications were also predicted with an increased MFI, the odds of a life-threatening complication increasing 488.20 times at an MFI of 3 ( p < 0.001). Discussion and Conclusion While surgical decision-making for frail patients with DRFs remains contentious, this novel 8-item MFI score was significantly associated with the probability of hospital readmission/reoperation, postoperative complications, and delayed hospital length of stay. Three new parameters were incorporated into our 8-item score compared with the conventional 5; hypoalbuminemia status (< 3.5 mg/dL), previous diagnosis of osteoporosis, and severe obesity (body mass index > 35) enhancing its sensitivity. Future studies are warranted for its prospective utility in ruling out postsurgical comorbidity.

CONSERVATIVE TREATMENT AND VITAMIN D LEVELS IN PATIENTS WITH SPINAL FRACTURES

ABSTRACT Objectives: Evaluate the evolution of pain, functional capacity, and vitamin D levels in conservatively treated patients with low-energy spinal fractures. Methods: Between January 2017 and March 2021, patients older than 40 years old affected by these fractures were selected and treated conservatively for six months. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores and Cobb angle were evaluated pre- and post-treatment. Serum vitamin D levels were also measured at the first outpatient visit, and it was investigated whether the patient had a previous diagnosis of osteoporosis or previous fractures. Results: A total of 105 patients were analyzed, 70.5% of whom were women, with a mean age of 73.1 years. The average vitamin D level was 25.3 ng/mL, and hypovitaminosis was found in 75% of patients. Eight patients (7.62%) had a previous diagnosis of osteoporosis, and ten (9.52%) reported the occurrence of previous fractures. Regarding the VAS score, there was a mean reduction of 5.5 points of pain; for ODI, there was an average increase of 1 percentage point and an average increase of 4.3º of kyphosis in the fractured segment between pre- and post-treatment. Conclusion: The treatment improved pain, and patients maintained their functional capacity. Low levels of vitamin D were associated with more complex fractures. Level of evidence III; Retrospective Study.

RF06 | PSAT155 Are We Following the Recommendations to Screen for and Treat the "Silent Killer" in Our Geriatric Population? A Quality Improvement Project

Abstract Introduction Osteoporosis is characterized by weakening of the bone, disruption of its architecture, and loss of skeletal strength, leading to increased risk of fragility fractures. According to the CDC, the prevalence of osteoporosis in 2017-2018 was 5.7% in males and 17.7% in adults aged 65 and older. Approximately 2 million osteoporosis fractures occur annually in the USA. The annual direct cost is estimated to be $25.3 billion by 2025. Implementing effective strategies to help with early diagnosis, treatment, and follow-up is fundamental. Our study aims to identify barriers that render the geriatric population with osteoporosis from receiving optimal medical care. Methods We retrospectively reviewed a sample of 119 patients of a GERIATRIC PACT Veteran administration (VA) clinic between 1/1/2018 and 8/30/2021 to identify patients diagnosed with osteoporosis and monitor the adequacy of education, treatment, and follow-up. Possible treatment barriers and subsequent consequences were noted. Results were presented using descriptive statistics. Results The mean age of the cohort was 83±7 years old, 90% (N=107) of them being males, with a mean BMI and Hb A1c of 27± 6 kg/m2 and 6. 0± 2.1%, respectively. From the total, we obtained a sample of 17.8% (N=15, 12M/3F) patients who had a previous diagnosis of osteoporosis without concurrent medical management. Eight patients (53%) didn't have Osteoporosis management or discussion of the treatment with the clinician at their initial geriatric appointment, and 5 patients didn't discuss osteoporosis in subsequent visits either. Poor mental or physical status, limiting patient follow-up or treatment, was identified in 40%(N=6) of the patients. Adverse reactions were seen in 6.6% (N=1). 20% of the patient were on drug holiday (N=3), and 20% (N=3) refused any osteoporosis treatment. 26.6%(N=4) of the patients had developed fragility fractures. From this subgroup, one patient refused the treatment, and 3 had no osteoporosis treatment discussion at their initial visit. Discussion Our results showed that a significant number of patients with osteoporosis had no screening or evaluation. Osteoporotic fractures were presented within a few months in 20% of them. No identifiable cost barriers or contraindications to osteoporosis treatment were noticed. Multiple factors could have contributed to these events. Lack of universal clinical reminder for osteoporosis screening per national VA guidelines fails to identify men at increased risk for osteoporosis and it does not address the lack of follow-up reminders on this topic. Public misinformation regarding osteoporosis treatment is another barrier that needs to be addressed with education. Plans to identify patients with no concurrent treatment are necessary. Conclusions In geriatric veterans, implementing tools to follow-up on patients with osteoporosis and identifying treatment barriers is an essential step for high-quality, integrated, and comprehensive patient care. Such tools need to be validated with future studies to ensure effectiveness. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m., Saturday, June 11, 2022 1:24 p.m. - 1:29 p.m.

Clinical characteristics and impact of treatment gap of fragility fractures in Colombia: experience of 10 Fracture Liaison Services (FLS)

Background &amp; aims. Fragility fractures are those caused by low-energy trauma or falls from standing height. The mortality after the first year of suffering a hip fracture ranges from 15 to 30%. This problem has been addressed through the creation of interdisciplinary programs for fragility fracture early diagnosis and prevention. Describing the clinical characteristics of a cohort of patients diagnosed with fragility fractures in 10 fracture liaison services in Colombia. Methods. Led by the Asociaci n Colombiana de Osteoporosis y Metabolismo Mineral, this is a cross-sectional descriptive study, in patients with a diagnosis of fragility fracture in 10 fracture liaison services. Demographic and clinical variables were described for one year from the diagnosis of the fracture. Results. were analyzed 1699 records of patient fractures between 50 and 101 years of age, 1334 were women (76.5%), 581/1484 (39.1%) had previous fragility fractures, 570/1599 (35.7%) had a previous diagnosis of osteoporosis. Of these, 70/1051 (7%) received anti-osteoporosis medication, and 311/733 (42.4%) received it post-fracture. Of the total records with information, 65/707 (9.2%) died the following year of the fracture. Conclusions. Fracture prevention programs in institutions allow for de16 A. Medina et al. tecting patients with fragility fractures, clinical characteristics of these, in addition to strengthening the conditions of a centralized national registry, based on the parameters of the International Osteoporosis Foundation - Capture the Fracture program, through strategies with multidisciplinary personnel.

PMS45 CLINICAL CHARACTERISTICS AND HEALTH OUTCOMES IN A GROUP OF ELDERLY PATIENTS WITH HIP FRACTURE IN MANIZALES, COLOMBIA.

To determine the sociodemographic and clinical variables associated with hip fracture and its complications on ambulation, functionality and survival in a population of older adults in Caldas, Colombia. Descriptive study. Adults of any sex over 65 years who entered the emergency department at SES Hospital de Caldas with a diagnosis of hip fracture, between January/2016-February/2018 were included. The information was obtained from the clinical records. Sociodemographic and clinical variables regarding the mechanism of fall, type of fracture and outcomes (complications, gait status and survival) were obtained. A total of 229 patients were identified, with a mean age of 80.4±7.8 years and female predominance (n=151, 65.9%). The main cause of falls during everyday activities (82.5%) mainly by slip or stumble and 29.7% had a previous diagnosis of osteoporosis. The main comorbidity was hypertension (68.6%). The average Barthel score at admission was 37.5±18.5. In addition, 95.6% of the patients were admitted to osteosynthesis or hip replacement surgery, with a mean of days from admission to procedure of 6.2 ± 25.2 days. When evaluating in-hospital complications, 37.6% of the patients presented hydroelectrolytic alterations, 31.0% delirium and 10.0% pneumonia. Among the outcomes evaluated, it was found that 44.5% of the patients had stood up at 48 hours and 69.4% were already walking at hospital discharge. It was possible to follow up 90 patients at 90 days, of those 67.8% were alive. Hip fractures in the elderly are a major public health problem. The timing of surgical intervention was prolonged and only two thirds of patients could walk at discharge. Research in this area is essential to identify and formulate strategies aimed to achieve the best health outcomes in this population.

Footedness related differences in femoral bone mineral density in elderly women with osteoporosis

Purpose: The presumed link between lateralized habitual motor activity and bilateral skeletal asymmetry, as result of bone functional adaptation, is the basis for inferences about bone mineral distribution; consequently, bone loss and osteoporosis. As there is no research connecting directly footedness with osteoporosis, the present study was designed to investigate their relation, in elderly women with osteoporosis.Methods: A sample of 420 white, Caucasian race women, older than 65 years, with previous diagnosis of osteoporosis, was recruited for the study. Finally, 164 women met the inclusion criteria and participated. The femoral neck and total hip bone mineral density (BMD) differences between right and left hips of 105 right-footed and 59 non-right-footed women, and the between footedness groups differences of the above right-left BMD differences, were measured with Dual-energy X-ray Absorptiometry (DXA).Results: In right-footers, total hip right-left BMD differences were statistically significant, favoring left femur [t(104) = –2.79, p < .01, two tailed]. In non-right-footers, femoral neck right-left BMD differences were statistically significant, favoring right femur [t(58) =2.025, p < .05, two tailed]. Femoral neck and total hip right-left BMD differences of right- versus non-right-footed women were statistically insignificant.Conclusion: The dominance of the right lower limb had an asymmetric effect on left total hip BMD, while non-right-footedness favored right femoral neck BMD. The findings highlighted the influence of load bearing effects of the body weight and muscle contractions on femoral BMD. We noted a possible association between footedness and BMD, as a result of bone functional adaptation.

A coordination project for improvement of osteoporosis medication use among patients who sustained an osteoporotic fracture: The Israeli experience

ObjectivesThe aim of this study was to examine whether coordination between healthcare providers at an inpatient rehabilitation facility and healthcare providers in a community setting improves osteoporosis medication use in the community. MethodsIn 2012, a coordination project between an inpatient geriatric rehabilitation facility located in north-central Israel and general practitioners in the community setting was initiated. In this retrospective pseudo-experimental study, we compared osteoporosis medication use among patients who were hospitalized at the facility following an osteoporotic fracture during 2011–2012, and who constituted the control group (n=120), and patients who were hospitalized at the facility during 2013–2015, and who constituted the trial group (n=129). Data were collected from the patients' records and from records of the health maintenance organization concerning medications issued to the patients by pharmacies. ResultsDifferences were observed between the trial and the control group in osteoporosis medication management by healthcare providers, both at the inpatient rehabilitation facility and in the community, suggesting favorable trends. However, osteoporosis medication use in the community was slightly lower in the trial group, then in the control group (32.8% vs. 34.2%, respectively). A regression analysis indicated that the only variable predicting use of osteoporosis medications in the community was a previous diagnosis of osteoporosis in the community. ConclusionsThe study results indicate that mere coordination between the healthcare settings is insufficient in order to ensure continued care in the community, emphasizing the need for an osteoporosis coordinator.

Rush Fracture Liaison Service for capturing "missed opportunities" to treat osteoporosis in patients with fragility fractures.

Determining the prevalence of undiagnosed and untreated osteoporosis in fragility fracture patients, either admitted to an academic tertiary care center or treated and discharged from the center's emergency department to be followed in the endocrinology bone clinic, using an innovative, educational, low-cost, physician-run Fracture Liaison Service (FLS). An automated alert was integrated into the electronic medical record at Rush University Medical Center (RUMC), triggered by historical and/or acute fracture(s) in patients 50years or older, in patients that were either admitted to the hospital or in patients evaluated in the emergency department and discharged to be followed in the endocrinology bone clinic. We report the results of the first 12months of operation in patients admitted to the hospital. First acute fragility fracture(s) were identified in 36% (80/223), only historical fragility fracture(s) in 28% (63/223) and both acute and historical fragility fracture(s) in 36% (80/223). The cumulative subgroup with historical fragility fractures with/without new fractures included 67% (96/143) without a previous diagnosis of osteoporosis. First acute fragility fracture group included 83.8% (67/80) without a previous diagnosis of osteoporosis. Rush FLS "captured missed opportunities" in 73.1% (163/223) of previously undiagnosed and 77.1% (172/223) of previously untreated osteoporosis patients. Dual-energy x-ray absorptiometry (DXA) prior to FLS consult was confirmed in 30% (67/223). Vitamin D deficiency (25-hydroxy vitamin D < 20ng/ml) in 41.9% (78/186) including undetectable levels in 16.6% (31/186) and secondary hyperparathyroidism in 43.3% (78/180) were the most common laboratory confirmed secondary etiologies for bone loss. This study reported undiagnosed, uninvestigated, and untreated osteoporosis in the majority of fragility fracture patients seen by the Rush FLS in the first 12months of operation.

The Effectiveness of Osteoporosis Screening and Treatment in the Midwest.

Introduction:With osteoporosis on the rise across the United States, the goal of this prospective study is to determine the effectiveness of our Midwest level-1 trauma center in diagnosing, treating, and educating osteoporosis patients after fracture with the use of questionnaires. Secondarily, we aimed to identify barriers that prevent our patients from complying with bone health recommendations.Methods:One hundred participants (≥55 years) were given 2 questionnaires (Fracture Risk Assessment Tool and a study-specific questionnaire) that were administered during the patient’s visit to the orthopedic trauma clinic. A group of patients diagnosed with osteoporosis was compared to a group of patients not diagnosed with osteoporosis. Statistical analyses were performed using SPSS 24 (IBM Corp, Chicago, Illinois).Results:Patients who had been diagnosed with osteoporosis were significantly older (72.7 vs 66.5, P = .009) and more were women (86.2% vs 66.2%, P = .043). Significantly, fewer patients without the diagnosis of osteoporosis had a history of fragility fracture (56.3%) compared to 92.9% of those diagnosed with osteoporosis (P < .001). Of those with dual-energy X-ray absorptiometry (DXA) recommended by a healthcare provider, 20 (55.6%) of those without the diagnosis of osteoporosis and 13 (52%) of those with the diagnosis of osteoporosis had DXA screening before their fragility fracture (P = .499). More patients diagnosed with osteoporosis (93.1%) were taking calcium and vitamin D supplementation compared to 66.2% of those without the diagnosis of osteoporosis (P = .005). Only 37.9% of patients with the diagnosis of osteoporosis were receiving US Food and Drug Administration–approved medications for the management of their disease.Discussion:In patients without previous osteoporosis diagnosis, 59 (83.1%) of the 71 claimed that they did not receive any preventative education about osteoporosis, while 21 (72.4%) of the 29 patients with the diagnosis of osteoporosis claimed that they did not receive a preventative education (P = .165). Both groups lacked optimum diagnosis, treatment, and education of osteoporosis.Conclusion:Our study highlights the need for a deliberate effort of a multidisciplinary team to focus efforts in all stages of osteoporosis management.

Risk of osteoporosis in elderly individuals attending a dental clinic

Osteoporosis has become a critical public health problem with the rapidly aging population in Japan. It is necessary for dentists to know their patients' status because it influences dental treatment. The purpose of this study was to predict the risk of osteoporosis in elderly patients visiting a dental clinic by assessing mandibular cortical morphology on panoramic radiographs. Three-hundred and thirty patients were divided into three classes based on the morphology of their mandibular cortex on panoramic radiographs. Mandibular cortical bone width at the mental foramen was also measured. Bone mineral density (BMD) was determined at the calcaneus using a quantitative ultrasound device. The mandibular cortical width decreased significantly from Class 1 (normal cortex), to Class 2 (moderately eroded cortex) and to Class 3 (severely eroded cortex). BMD was negatively correlated with age in both female and male patients. Most (108/186) female patients had a class 3 cortex with a low BMD. Among women, mandibular cortical width was significantly correlated with BMD. Thirty-three percent of the female had received a previous diagnosis of osteoporosis. In contrast, only 13.9% (20/144) of the male had a Class 3 cortex. In men, mandibular cortical width did not significantly correlate with BMD. Only a few of the men had received a previous diagnosis of osteoporosis. The number of remaining teeth did not correlate with low BMD in either sex. Our findings reveal that most elderly female patients visiting the dental clinic had a high risk of osteoporosis and a low BMD.

A Survey of Osteoporosis and Breast Cancer Risk Perception among Menopausal and Postmenopausal Women in Hong Kong.

ObjectivesA lack of understanding in menopausal and postmenopausal women's (PMW) risk perception towards osteoporosis and breast cancer still exists, which is explored in this study. This information might allow health professionals to conduct interventions to improve health behaviors before menopause-related diseases are imminent.MethodsBetween 10 December 2015 and 31 January 2016, 573 menopausal or PMW were successfully interviewed on 17 questions, comprising separate sections for osteoporosis and breast cancer. The target respondents were menopausal or PMW aged 45 to 60 years, with no previous diagnosis of osteoporosis or breast cancer, who attended private clinics across Hong Kong for annual physical examination.ResultsRegarding menopausal issues, the top three concerns were osteoporosis and fracture (72%), breast cancer (44%), and sleep disorder/insomnia/headache (40%). Among 314 respondents (55%) who tried to prevent osteoporosis, 74% of them began to do it after they were 40 years old. On the other hand, 65% of respondents never had a bone density test. For respondents who said “I'm too young, so I don't need to check”, their mean age was 52 years old. Ninety percent of respondents mistakenly believed that regular breast examination, regular breast massage, drink soy milk, or vaccine can prevent breast cancer.ConclusionsThis survey revealed osteoporosis and breast cancer as the top concerns among menopausal and PMW in Hong Kong. Inadequate health behaviors and misconceptions still exist despite widespread health education in the recent years.

Vitamin D status in healthy Moroccan men and women aged 50years and older: a cross-sectional study.

This study aimed to compare the vitamin D status in healthy Moroccan men and women aged 50years and older. A total of 186 Moroccan women and 68 men, who had no previous diagnosis of osteoporosis, were recruited prospectively. We found in this study a high prevalence of hypovitaminosis D with no difference between men and women. The main purpose of this study was to describe and compare the vitamin D status, parathormone, calcium, and phosphate of healthy Moroccan men and women aged 50years and older. We conducted two cross-sectional studies, in postmenopausal women from October 2008 to November 2009 and in men over 50years old, from December 2009 to August 2010. A total of 186 Moroccan women and 68 men, who had no previous diagnosis of osteoporosis, were recruited prospectively. For the definition of hypovitaminosis D, the preferred level for 25-hydroxyvitamin D (25(OH)D) insufficiency, which is now recommended by many experts, is 30ng/mL (75nmol/L), and the levels below 10ng/ml (25nmol/L) indicate deficiency. The prevalence of vitamin D deficiency in men and women was 4.4 and 8.6%, respectively, and the prevalence of vitamin D(25(OH) D) insufficiency in men and women were 85.2 and 77.4%, respectively. In men and women, no correlations were found between intact parathormone (PTHi) and 25(OH) D (r = 0.056). Despite a sunny environment, we found in this study a high prevalence of hypovitaminosis D (insufficiency + deficiency) in Moroccan men over 50years old and postmenopausal women.

Relationships between vertebral fractures, sex hormones and vitamin D in Moroccan postmenopausal women: a cross sectional study.

BackgroundVertebral Fractures (VFs) are associated with bone loss that occurs before menopause but is accelerated at menopause as a result of sex hormone deficiency.To determine the association of sex hormones, bone remodeling markers and vitamin D levels with bone mineral density (BMD) and asymptomatic VFs prevalence using vertebral fracture assessment (VFA) in a cohort of Moroccan menopausal women.MethodsThis was a cross-sectional study conducted from October 2012 to April 2013 with menopausal women aged 50 years old and over. A total of 207 women who had no previous diagnosis of osteoporosis were enrolled in this cross-sectional study. Women were recruited prospectively from our laboratory department. VFA images and scans of the lumbar spine and proximal femur were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genant semiquantitative approach and morphometry. Serum levels of estradiol, dehydroepiandrosterone sulfate, Sex hormone binding globulin, vitamin D, Osteocalcin, Crosslaps, intact parathormone were measured by Electrochemiluminescent immunoassay technique.ResultsAmong the 207 women, 18.3 % (n = 38) had densitometric osteoporosis. On VFA, VFs were detected in 134 (62.3 %), including 96 (44.6 %) grade 1 and 38 (17.6 %) grade 2/3. There was no difference in the plasma levels of sex steroids, bone remodeling markers and vitamin D in the group of women with VFs (grade 1 and grade 2/3) and without VFs. The combination of variables that best predicted grade 2/3 VFs included the number of years since menopause and the lumbar spine T-score.ConclusionThese data confirm the importance of postmenopausal estrogen and SHBG concentrations in the bone loss and the pathogenesis of osteoporosis in elderly women, but not in the occurrence of the VFs.

High prevalence of fragility vertebral fractures in patients hospitalised in Internal Medicine Units. Results of the POINT (Prevalence of Osteoporosis in INTernal medicine) study

BackgroundOsteoporotic vertebral fractures (VFs) often go unrecognised in both healthy individuals and in pathological conditions. Few data exist on VFs in patients hospitalised in Internal Medicine Units (IMUs), who often suffer from multiple concomitant chronic disorders. Aim of the studyThis multicentre cross-sectional study was aimed at assessing the prevalence of VFs in an unselected population of patients referring to IMUs. Correlations between VFs and the main coexisting diseases were also investigated. MethodsInformation on demographic, clinical and laboratory findings, and on the presence of known risk factors for osteoporosis was recorded. The Genant's semi-quantitative method was used to evaluate, in a central reading centre, the presence and severity of VFs in the thoracic and lumbar spine. ResultsA cohort of 995 patients was evaluated. At least one VF of any grade was found in 47.5% of patients, with similar prevalence between females (48.1%) and males (46.7%). Older age, chronic obstructive pulmonary disease, and previous diagnosis of osteoporosis showed a significant association with VFs in multivariable analysis. However, 79.7% of the VFs were observed in patients without previous diagnosis of osteoporosis. Moreover, a VF of grade 2 or greater was found in 20.8% of patients. ConclusionsFragility VFs is a very frequent finding in patients hospitalised in IMUs. Consequently, more attention should be devoted in this clinical setting to this comorbidity, which is known to be an additional factor for mortality and, when localised in the thoracic part of the spine, may negatively influence a concomitant respiratory insufficiency.

Relationship between sex hormone levels, bone mineral density and bone turnover markers in healthy moroccan men: a cross-sectional study.

IntroductionGonadal steroid hormones play a crucial role during skeletal growth and maturation in both men and women. The aim of this study is to evaluate the relationship of sex hormone levels, bone mineral density and biochemical markers of bone turnover in healthy Moroccan men.Methods142 Moroccan men who had no previous diagnosis of osteoporosis were enrolled prospectively in this cross-sectional study between December 2009 and August 2010. Also, subjects were excluded from the study if they had conditions affecting bone metabolism. Different biochemical parameters were assayed: Testosterone, Estradiol, sex hormone binding globulin, Osteocalcin, vitamin D, crosslaps, intact parathyroid hormone and alkaline phosphatase. Dual-energy X-ray absorptiometry was used to measure the Bone mineral density (BMD) (g/cm2).ResultsIn this study, among the 142 Moroccan men, 29 (20.1%) had densitometry osteoporosis and the prevalence of vitamin D insufficiency was 94%. No correlation was found between Estradiol, Testosterone and bone mineral density but we found significant differences in the levels of Estradiol between patients with osteoporosis, osteopenia and normal patients. Bone mineral density at the lumbar spine was negatively correlated to hormone-binding globulin and positively correlated to free androgen index, free estrogen index and the Body mass index. BMD at the total hip was positively correlated to free androgen index, Body mass index and negatively correlated to sex hormone binding globulin, alkaline phosphatase, intact parathyroid hormone, osteocalcin, Crosslaps and age.ConclusionOur study showed that increasing age, intact parathyroid hormone and alkaline phosphatase levels and decreasing body mass index were the most important independent factors associated to the presence of a low BMD at the total hip. Increasing body mass index and free androgen index level were the most important independent factors associated to the presence of a low BMD at the lumbar spine. The combination of variable that best predicted the male osteoporosis is age, body mass index, alkaline phosphatase and cigarette smoking.

Prevalence of osteoporotic vertebral fracture in Spanish women over age 45

The aim of this work is to study the prevalence of osteoporotic vertebral fractures in Spanish women over 45 years of age, based on the selection of a nationwide sample. An observational, cross-sectional, multicenter study was conducted during 2006, in all of Spain's regions. The sample analyzed was of 5000 individuals, representative of the female population over age 45 in Spain.A questionnaire was used to determine which factors are most often associated with vertebral fractures. We also assessed whether the Prevalent Vertebral Fracture Index, proposed by Vogt, is useful in indicating a possible osteoporotic vertebral fracture. Five hundred orthopedic surgeons, from various Spanish regions, were trained in different aspects of the study: inclusion and exclusion criteria, management of the risk factor questionnaire, and implementation of the Vogt questionnaire.The number of fracture cases was 1549 (31.79%). 528 Women (34.08%) had a single vertebral fracture, and 1021 (65.92%) had multiple vertebral fractures. The following factors were statistically significantly associated with vertebral fracture: age, late menarche, early menopause, diabetes mellitus, hyperparathyroidism, rheumatoid arthritis, height loss, daily physical activity, corticosteroid therapy, personal history of osteoporotic fracture and previous diagnosis of osteoporosis. The differences in Vogt score according to age and fracture status were statistically significant.The conclusion of the study is that vertebral osteoporotic fracture in the female Spanish population is frequent. The high prevalence in the Spanish population older than 60 years is probably related to malnutrition in the period from 1936 to 1952.

Women's experiences of their osteoporosis diagnosis at the time of diagnosis and 6 months later: A phenomenological hermeneutic study

This paper describes a phenomenological hermeneutic study of experiences of women who were recently diagnosed with osteoporosis. The research objective was to investigate women's experiences of living with osteoporosis during the first 6 months after diagnosis when treatment was first prescribed. Fifteen women were included in the study. The inclusion criteria were a DXA scan at one of the two hospitals showing a T-score below −2.5 (lower back or hip), age 65 years or older; no previous known osteoporotic fracture; at least one of the known risk factors for osteoporosis; and prescription of anti-osteoporotic treatment. Exclusion criteria were previous diagnosis of osteoporosis or previous treatment with anti-osteoporotic medication. Data were collected through in-depth interviews shortly after diagnosis and 6 months later. The performed analyses were inspired by Paul Ricoeur's theory of interpretation of texts comprising three levels: naïve reading, structural analysis, and critical interpretation and discussion. Three key themes emerged: 1) being diagnosed, 2) being prescribed medical treatment, and 3) being on the path of learning to live with osteoporosis. The findings suggest a need for improved support for the patients to gain understanding of their diagnosis and the risk of osteoporotic fracture as well as to learn to live with osteoporosis. The study highlights new health promotion areas for targeting interventions at newly diagnosed patients, helping them accept and interpret the diagnosis, and the medical treatment.

Appropriate Osteoporosis Treatment by Family Physicians in Response to FRAX vs CAROC Reporting: Results From a Randomized Controlled Trial

Canadian guidelines recommend either the FRAX or the Canadian Association of Radiologists and Osteoporosis Canada (CAROC) fracture risk assessment tools to report 10-yr fracture risk as low (<10%), moderate (10%–20%) or high (>20%). It is unknown whether one reporting system is more effective in helping family physicians (FPs) identify individuals who require treatment. Individuals ≥50 yr old with a distal radius fracture and no previous osteoporosis diagnosis or treatment were recruited. Participants underwent a dual-energy x-ray absorptiometry scan and answered questions about fracture risk factors. Participants' FPs were randomized to receive either a FRAX report or the standard CAROC-derived bone mineral density report currently used by the institution. Only the FRAX report included statements regarding treatment recommendations. Within 3 mo, all participants were asked about follow-up care by their FP, and treatment recommendations were compared with an osteoporosis specialist. Sixty participants were enrolled (31 to FRAX and 29 to CAROC). Kappa statistics of agreement in treatment recommendation were 0.64 for FRAX and 0.32 for bone mineral density. The FRAX report was preferred by FPs and resulted in better postfracture follow-up and treatment that agreed more closely with a specialist. Either the clear statement of fracture risk or the specific statement of treatment recommendations on the FRAX report may have supported FPs to make better treatment decisions.

AB1010 The absence of the diagnosis of osteoporosis, in patients with hip fractures due to fragility

BackgroundOsteoporosis is a disease whose risk factors are well known, in spite of which remainsunderdiagnosed until a fracture occurs.ObjectivesTo describe the different characteristics of the population admitted for hip fracture...

Comparison of Accuracy of Prediction of Osteoporosis in Digital Panoramic Radiography with DEXA Scan in Postmenopausal Women: A Pilot Study

Aims and objectives: To compare the accuracy of prediction of osteoporosis in digital panoramic radiography with Dual Xray absorptiometry (DEXA) scans and serum investigations such, as calcium, phosphorous, alkaline phosphatase in postmenopausal women. The objective of the study is to detect the appearance of eroded mandibular cortex (cortical shape), inferior cortical width appearance on Digital panoramic radiographs in post menopausal women, bone mineral density, with DEXA scan and serum calcium, phosphorous and alkaline phosphatase levels in postmenopausal women. The main objective of this study is to compare both tools (Digital OPG and DEXA scans) to detect similar diagnostic performances in identifying post-menopausal women with osteoporosis. Materials and methods: This is a study in the Outpatient department of Oral Medicine Diagnosis and Radiology and Bharat Scan Centre designed to compare the accuracy of prediction of osteoporosis in digital panoramic radiography with DEXA scan in postmenopausal women without estrogen use and with and without history of hysterectomy, oopherectomy and with normal values of serum calcium, phosphorous and alkaline phosphatase. The study includes 10 postmenopausal women varying in age group between 60 and 75 years who reported to the outpatient department of oral medicine diagnosis and radiology, seeking dental treatment. The BMD with digital panoramic radiography, DEXA-scan and serum calcium, phosphorous, and alkaline phosphatase levels were calculated and compared. Results: In our study, out of the10 postmenopausal women with no previous diagnosis of osteoporosis, who participated in this study, 3 women (30%) were normal, 1 woman (10%) had osteopenia and 6 women (60%) had osteoporosis on the basis of BMD. There is significant relationship in the width of the mandibular cortex for normal, osteopenic and osteoporosis patients. The cortical width was reduced and less than 4 mm in our study for patients with osteoporosis. The cortical width was normal and greater than 4 mm in our patients without osteoporosis. The mean cortical width of patients with osteoporosis was 2.7 mm, 3.9 mm for osteopenic patients, 4.18 mm for patient without osteoporosis. Conclusion: The purpose of this study is that dentists may be able to refer postmenopausal women with undetected low skeletal BMD or osteoporosis to medical professionals for further examination on the basis of incidental findings on dental panoramic radiographs.