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Elder Care News
Risk of
Falling Is Overlooked as the Major Cause of Fractures in the Elderly
Evidence says
fall prevention can reduce falls by up to 50%
 Jan. 18, 2008
There has been a splash of recent news on the benefits of vitamin D2
with calcium in preventing bone loss and resulting fractures in senior
citizens. A new report, however, says this is the wrong focus for
preventing factures in the elderly: it should be on preventing falls.
An elderly
person's risk of falling is too often overlooked when trying to prevent
them from getting serious fractures, for instance of the hip or wrist,
according to an article published in this weeks BMJ.
The Finnish
authors says studies show that if the focus were to be switched to how
at risk someone is of falling, rather than whether they have the bone
disease osteoporosis, then considerably more fractures in elderly people
could be prevented. However, many important publications completely
overlook falling as a risk factor and it is still very poorly recognised
and assessed by doctors.
Dr Jarvinen
and colleagues say current fracture prevention methods have serious
limitations. At the moment an individual is screened to see whether they
have osteoporosis, and is then treated accordingly with medication.
Yet the test
which determines whether someone has the disease is flawed. It assesses
bone mineral density (BMD) and can often either over and under-estimate
that density. BMD is therefore a poor predictor of whether a person is
likely to suffer a fracture and is of little diagnostic value to a GP.
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Summary Points
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● Falling, not osteoporosis, is the
strongest single risk factor for fractures in elderly people
● Bone mineral density is a poor
predictor of an individuals fracture risk
● Drug treatment is expensive and
will not prevent most fractures in elderly people
● Randomised controlled trials show
that falls in older people can be reduced by up to 50%
● General practitioners should shift
the focus in fracture prevention by systematically assessing risk of
falling and providing appropriate interventions to reduce the risk
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The cost of
using drugs to prevent fractures in the elderly is also extremely high.
For example the researchers calculated that 577 postmenopausal women
would have to be treated with osteoporosis drugs (known as
bisphosphonates) for one year to avert one hip fracture, at a cost of
about $235 032 (£120,000).
Among a high
risk population (women over 80), for whom drug prevention would
theoretically be most effective, prevention of one hip fracture costs
about $55
820 (£28,500).
Yet 80% of hip
fractures would still occur.
The authors
say falling is the major cause of nine in ten hip fractures and drug
therapy would not prevent more fractures because the drugs cannot be
expected to work on fall-related risk factors.
Eight in ten
fractures also occur in people who do not even have osteoporosis.
The authors go
on to say it is important for GPs to identify at-risk individuals and
assess their needs.
Current
evidence-based recommendations for preventing falls include regular
strength and balance training, taking Vitamin D and Calcium supplements
and an assessment of the possible hazards in the homes of at-risk
people.
There is
evidence that fall prevention efforts can reduce the incidence of falls
by up to 50% in the elderly.
▪ Click here
to view full paper:
http://press.psprings.co.uk/bmj/january/ac124.pdf
▪ Click here
to view full contents for this week's print journal:
http://press.psprings.co.uk/bmj/january/contents1901.pdf
Shifting the
focus in fracture prevention from osteoporosis to falls BMJ Volume 336,
pp 124-6
Stores in "Nutrition, Vitamins & Supplements for Seniors"
Archives
Calcium Loses Ability to Prevent Bone Loss Unless
Bolstered with Vitamin D
Study of elderly women finds D2 with
calcium keeps on working
 Jan. 17, 2008 Elderly women fighting to prevent
bone loss saw their calcium pills become no more effective than placebos
after about three years, in a recent study. The researchers found,
however, that combining vitamin D with the calcium sustained the bone
loss prevention throughout the five year study.
Read
more...
Vitamin D2 Helps Prevent Falls Among High-Risk Female Senior Citizens
 Vitamin D2 reduced risk of having at least one fall
by 19%
Jan.
14, 2008 - Vitamin D2 supplements appear to reduce the risk of falls
among senior citizen women with a history of falling and low blood
vitamin D levels living in sunny climates, especially during the winter,
according to a report in the January 14 issue of Archives of Internal
Medicine, one of the JAMA/Archives journals.
Read more &
links to more on vitamin D...
Calcium Supplements Don't Work for Elderly Women to
Prevent Fractures They Won't Take Them
You can lead an elderly woman to
her medicine, but can't make her take it
April 25, 2006
Vitamin D for
Elderly Could Reduce Leading Cause of Injury Deaths
Oct. 27, 2004
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