Non-Pharmacological Interventions towards Preventing the Triad Osteoporosis-Falls Risk-Hip Fracture, in Population Older than 65. Scoping Review

Abstract

Osteoporosis leads to increased risk of falls, and thus an increase in fractures, highlighting here hip fractures, that result in high mortality, functional disability, and high medical expenditure. The aim is to summarise the available evidence on effective non-pharmacological interventions to prevent the triad osteoporosis/falls risk/hip fracture. A scoping review was conducted consulting the Scientific Electronic Library Online (Scielo), National Institute for Health and Care Excellence (NICE), Cumulative Index to Nursing & Allied Health Literature (CINAHL) y PubMed.databases. Inclusion criteria were articles published between 2013 and 2019, in Spanish or English. In addition, publications on a population over 65 years of age covering non-pharmacological interventions aimed at hip fracture prevention for both institutionalised patients in long-stay health centres or hospitals, and patients cared for at home, both dependent and non-dependent, were included. Sixty-six articles were selected and 13 non-pharmacological interventions were identified according to the Nursing Interventions Classification taxonomy, aimed at preventing osteoporosis, falls, and hip fracture. The figures regarding the affected population according to the studies are alarming, reflecting the importance of preventing the triad osteoporosis, falls risk, and hip fracture among the population over 65 years of age. The most effective interventions were focused on increasing Bone Mineral Density through diet, exercise, and falls prevention. As a conclusion, primary prevention should be applied to the entire adult population, with special emphasis on people with osteoporosis.

Risk of hip fracture in meat-eaters, pescatarians, and vegetarians: results from the UK Women’s Cohort Study

“…Hip fractures are most common in elderly women [ 1 ] and are becoming increasingly prevalent in the UK and globally due to growing ageing populations [ 2 , 3 ]. Health-related quality of life declines after hip fracture and mortality increases [ 1 , 4 ]. Social and economic costs from hip fractures are also substantial [ 2 ], with an international average cost 12 months after the first hip fracture of $44,000 per patient [ 5 ].…”

Dietary risk factors for hip fracture in adults: An umbrella review of meta-analyses of prospective cohort studies

“…Hip fracture in particular affects 18% of women and 6% of men globally; because the global population continues to age and grow, cases are projected to rise from 1.26 million in 1990 to 4.5 million by 2050 [ 2 ]. Hip fracture patients are at increased risk for other health problems, such as a decreased quality of life due to impaired mobility, and increased morbidity and mortality [ 1 , 3 , 4 ]. The economic burden is also high because of direct costs due to long hospitalisation and rehabilitation periods, and additional indirect costs associated with comorbidities [ 2 ].…”

“…However, their evaluation of the quality of evidence for these associations was based only on the consistency of results, and did not account for potential biases or imprecision. A recent scoping review also synthesised the evidence for non-pharmacological interventions in preventing hip fracture, but evidence for diet was restricted to nutritional supplementation in older adults, with little to no evidence on dietary patterns or dietary intake of foods or nutrients and hip fracture risk [ 4 ]. Therefore, we aimed to summarise the totality of evidence regarding dietary risk factors for hip fracture in adults, evaluating the quality of evidence, to provide recommendations for practice or further research.…”

Sarcopenia and Malnutrition Screening in Female Osteoporosis Patients—A Cross-Sectional Study

“…By now, screening for sarcopenia and malnutrition is not generally established in clinical routine care for osteoporosis patients, and accordingly, harmonized strategies and large-scale randomized trials of how to approach that additional risk are missing. However, there is growing evidence regarding beneficial effects of nutritional intervention and specifically high-intensity exercise programs on bone health [ 17 , 40 , 41 , 42 ].…”