Osteoporosis Diagnosis and Management in Long-Term Care Facility

Am J Med Sci. 2015 Nov;350(5):357-63. doi: 10.1097/MAJ.0000000000000562.

Abstract

Background: Contemporary estimates of the prevalence of diagnosed osteoporosis among long-term care facility residents are limited.

Methods: This chart review collected data between April 1, 2012 and August 31, 2013 for adult (age ≥ 30 years) residents of 11 long-term care facilities affiliated with the Louisiana State University Health Sciences Center in the New Orleans metropolitan area. Data (demographics; comorbidities; osteoporosis diagnosis, risk factors, diagnostic assessments, treatments; fracture history; fall risk; activities of daily living) were summarized. Data for residents with and without diagnosed osteoporosis were compared using χ tests and t tests.

Results: The study included 746 residents (69% women, mean [SD] age: 76.3 [13.9] years, median length of stay approximately 18.5 months). An osteoporosis diagnosis was recorded for 132 residents (18%), 30% of whom received a pharmacologic osteoporosis therapy. Fewer than 2% of residents had bone mineral density assessments; 10% had previous fracture. Calcium and vitamin D use was more prevalent in residents with diagnosed osteoporosis compared with other residents (calcium: 49% versus 12%, vitamin D: 52% versus 28%; both P < 0.001). Over half (304/545) of assessed residents had a high fall risk. Activities of daily living were similarly limited regardless of osteoporosis status.

Conclusions: The prevalence of diagnosed osteoporosis was higher than previously reported for long-term care residents, but lower than epidemiologic estimates of osteoporosis prevalence for the noninstitutional U.S.

Population: In our sample, osteoporosis diagnostic testing was rare and treatment rates were low. Our results suggest that osteoporosis may be underdiagnosed and undertreated in long-term care settings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon / methods
  • Activities of Daily Living
  • Aged
  • Bone Density Conservation Agents / therapeutic use*
  • Female
  • Fractures, Bone* / epidemiology
  • Fractures, Bone* / etiology
  • Fractures, Bone* / prevention & control
  • Geriatric Assessment / methods
  • Homes for the Aged / statistics & numerical data*
  • Humans
  • Long-Term Care / methods
  • Long-Term Care / statistics & numerical data
  • Male
  • New Orleans / epidemiology
  • Nursing Homes / statistics & numerical data*
  • Osteoporosis* / complications
  • Osteoporosis* / diagnosis
  • Osteoporosis* / drug therapy
  • Osteoporosis* / epidemiology
  • Prevalence
  • Retrospective Studies
  • Risk Factors

Substances

  • Bone Density Conservation Agents