Bone Health in Nursing Home Residents in Germany – Do We Care Enough?

Introduction Most fractures occur in elderly people. Osteoporosis and fractures are main determinants of morbidity and mortality in the elderly. Especially frail people residing in nursing homes are at an exceptionally high risk to fall and fracture. In Germany, nevertheless, accurate data on the prevalence and treatment of osteoporosis in nursing home residents are not available.

Methods Objectives: To investigate the current state of medical care (cross-sectional data) and clinical outcomes of guideline-based fracture prevention strategies according to the current DVO Guideline (longitudinal data) in a supraregional, non-interventional study (NIS) in nursing home residents (aged 60-95 years) in Germany. The recruitment for this NIS is still ongoing. Methods: Analysis of preliminary, cross-sectional data on the first 386 participants from 7 Berlin nursing homes. The analysis focused on documented prevalent fractures, fracture risk assessment (using FRAX) and number of patients treated for osteoporosis.

Results Among the overall 386 participants, 286 (74.1%) are women, 100 (25.9%) men. The mean age at baseline was 82.7 years (±7.7 years), the median age was 84 years. 26.4% of the participants had a history of major osteoporotic fractures (MOF), 20.2% had prevalent hip (n=46) and/or clinical vertebral fractures (n=39). A 10-year fracture risk calculated by FRAX of≥20% for MOF and≥10% for hip fractures was found in 56.7% and 60.1%, respectively. Even though not all clinical data were available in some cases at the time of the analysis, at least 248 participants (64.2% of the entire cohort) had one or more indications for an anti-osteoporotic medication. However, only 34 of them (11.9%) received such treatment. The treatment rate was somewhat higher (23.1%) in participants with documented clinical vertebral or hip fractures.

Discussion Among the nursing home residents included in this first analysis the number of participants at high fracture risk and in need of an anti-osteoporotic treatment is high. Our data, however, provide evidence that the treatment rate in these individuals might be even lower than repeatedly reported for osteoporosis patients in general in Germany.

Keywords osteoporosis, major osteoporotic fractures (MOF), fracture risk, elderly, nursing home

Korrespondenzadresse Oliver Bock, OsteoPro Berlin-Friedenau, Rheinstr. 22, 12161 Berlin, Deutschland, E-Mail: [e-mail]

 

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Artikel online veröffentlicht:
08. September 2022