Bone Health in Nursing Home Residents

Osteoporosis management in Australian aged care facilities: a mixed method study

“…The finding that 35.0% of residents had osteoporosis is consistent with a previous Australian study that reported 34.1% of residents had a documented osteoporosis diagnosis [ 5 ]. However, this is significantly lower than the estimated 80–85% prevalence rate based on BMD testing of aged care residents [ 2 ]. A potential contributing factor to underdiagnosis is that of incomplete medical histories being provided to aged care facilities at the time of resident admission [ 10 ].…”

Pharmacological Management of Osteoporosis in Nursing Home Populations: A Systematic Review

“…These utilization patterns may indicate careful discussions between clinicians and patients or their families regarding treatment choice, but the low rate of medication use may also reflect poor recognition of osteoporosis. Osteoporosis is underdiagnosed and underrecognized in community and institutional populations 35,36 . Alternatively, these medications may be used for purposes other than osteoporosis treatment, influencing the patterns of medication use.…”

ASHP Therapeutic Position Statement on the Prevention and Treatment of Osteoporosis in Adults

“…Other factors associated with the higher fracture rate among nursinghome residents include immobility, low body mass, difficulty transferring (e.g., moving from a bed to a wheelchair), falls, and multiple medications. 142 In addition, many nursing-home residents have inadequate nutritional status, including low intake of calcium and vitamin D as well as inadequate sunlight exposure. 142,143 Osteoporosis treatment for nursing-home residents ideally involves a multifactorial approach emphasizing fall prevention, adequate nutrition, strength and balance training, medication review, and environmental modifications (e.g., redesigning home environments, removal of floor rugs).…”

“…142 In addition, many nursing-home residents have inadequate nutritional status, including low intake of calcium and vitamin D as well as inadequate sunlight exposure. 142,143 Osteoporosis treatment for nursing-home residents ideally involves a multifactorial approach emphasizing fall prevention, adequate nutrition, strength and balance training, medication review, and environmental modifications (e.g., redesigning home environments, removal of floor rugs). While devices such as hip protectors have been shown to prevent fractures in patients at high risk, 144 more recent data indicated that these are ineffective interventions.…”