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The risk of fractures in older adults doubles in the year following a hospital admission, according to a new study, and the risk increases with each additional hospitalization. The researchers urge healthcare providers to consider the hospitalization of an older adult as an opportunity to reduce his fracture risk.
The study, funded by the National Institute on Aging, included 3,075 men and women ages 70 to 79 who hadn't been treated for active cancer within the previous 3 years and who could walk a quarter mile, climb 10 steps, or perform activities of daily living without trouble.
During an average 6.6 years of follow-up, 66% of the people were admitted to a hospital and 26% were admitted three or more times. Researchers identified 362 fractures after discharge in 285 people, including 74 hip fractures. After accounting for age, race, and sex, they found that people who'd been hospitalized had a twofold increased risk of fracture.
The risk of fracture was greatest during the first year after hospitalization and increased with the number of hospitalizations. Researchers recommend assessing patients for fracture risk while they're in the hospital and intervening as necessary. According to the study authors, evaluations should include measurement of bone mineral density, vision testing, and fall risk assessment. Appropriate treatments could include calcium and vitamin D supplements, bisphosphonate therapy, vision correction, and physical therapy to improve flexibility, strength, and balance.
Gardner RL, Harris F, Vittinghoff E, Cummings SR. The risk of fracture following hospitalization in older women and men. Arch Intern Med. 2008;168(15):1671-1677.
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