Screening Postmenopausal Women for Fall and Fracture Prevention

Abstract

Fragility fracture prevention has been historically associated with the diagnosis and treatment of osteoporosis. Given that the strongest determinant of fracture is falls, it is critical to add fall risk into clinical decision-making guidelines for fracture prevention. This special interest paper proposes an algorithm based on 2 validated tools: (1) World Health Organization's Fracture Risk Assessment Tool, which evaluates probability of fracture and (2) Functional Gait Assessment, which evaluates fall risk. Physical therapists can use this algorithm to better identify patients at greatest risk for fracture in order to customize interventions designed to promote bone health, minimize falls, and ultimately prevent fractures. Recommendations for referral, patient education, and exercise are provided for categories of varying fall and fracture risk.

Associations Between Reported Dietary Sodium Intake and Osteoporosis in Korean Postmenopausal Women: The 2008-2011 Korea National Health and Nutrition Examination Survey

“…18 Koreans frequently dine out and regularly consume liquid cuisines, such as Jjigaes, which contain salt and salt-fermented food 7 ; these eating habits may help explain, in part, why the Korean population consumes such a high salt diet. Various factors are attributed to the development of osteoporosis, including a lack of physical activity, smoking, and calcium deficiency [19][20][21] ; however, sodium intake is not widely regarded as a risk factor for osteoporosis. Although there is a steady stream of campaigns aimed at reducing salt intake to prevent and treat hypertension, 7,22 few similar campaigns have been aimed at preventing osteoporosis among postmenopausal women.…”

“…Various factors are attributed to the development of osteoporosis, including a lack of physical activity, smoking, and calcium deficiency 19-21 ; however, sodium intake is not widely regarded as a risk factor for osteoporosis. Although there is a steady stream of campaigns aimed at reducing salt intake to prevent and treat hypertension, 7,22 few similar campaigns have been aimed at preventing osteoporosis among postmenopausal women.…”

Identification of risk factors for falls in postmenopausal women: a systematic review and meta-analysis

“…Many published studies have suggested that independent risk factors for falls in postmenopausal women may be related to smoking, menopausal age, bone density, drug use and previous medical history [11,13]. However, since the published literature contains mostly single-centre cohort studies, they differ in the identification of certain risk factors (such as alcoholism and hormone use) [14][15][16], and further research is urgently needed to identify the risk factors for falls in postmenopausal women.…”

Screening for Osteoporosis Risk Among Community-Dwelling Older Adults: A Scoping Review

“…9,[78][79][80] These interventions can potentially decrease fall and fracture risk and improve a client's quality of life. [79][80][81] A recent Delphi consensus on physical activity guidelines for persons with OP concluded that clients with OP should be assessed by an exercise professional for fracture risk, fall risk, posture, and physical performance parameters such as strength, pain during movement, gait speed, body mechanics, balance, flexibility, and aerobic capacity. 9 Those with OP plus known spinal fractures are recommended for physical therapy consultation and treatment for education on spinesparing techniques and supervised exercise prescription to prevent fall and fracture risk.…”