Osteoporosis in patients with dementia is associated with high morbidity and mortality: Findings from a single orthogeriatric unit

Abstract

Background and objectives Osteoporosis and dementia are common and associated with a high healthcare burden. The aim of this paper was to assess the impact of dementia on treatment, morbidity and mortality in osteoporosis. Methods Data were collected on 502 prospective orthogeriatric admissions for fracture. Fisher's exact chi-square was used to compare treatment stratified by dementia status. Results Of the 502 patients, 281 (56%) had osteoporosis, 226 (45%) had dementia, and 156 (31%) had dementia and osteoporosis diagnosed before they sustained fractures. Patients with dementia were more likely to have osteoporosis but less likely to be receiving treatment. Although there was a significant improvement in discharge versus admission rates of osteoporosis treatment, those with dementia were less likely to be treated with antiresorptive therapy (36%, compared with 59%, P <0.001) or combined therapy (32%, compared with 56%, P <0.001) and had double the 90-day mortality (17.3%, compared with 9.6%) and six times the 30-day mortality (6.4%, compared with 1.6%). Discussion Patients with dementia and osteoporosis have a higher risk of recurrent fractures and mortality. Prevention may be the key strategy.

Optimization of transdisciplinary management of elderly with femur proximal extremity fracture: A patient-tailored plan from orthopaedics to rehabilitation

“…In contrast, it has been reported that dementia could be strictly linked to osteoporosis[ 90 ]. However, bone health management could be frequently underestimated in the elderly with cognitive impairment due to the short life expectancy of these patients[ 91 ]. On the other hand, a growing number of papers underlined poor compliance with osteoporosis drugs, especially in patients with dementia or elderly with polypharmacotherapy[ 92 ].…”

Crosstalk of Brain and Bone—Clinical Observations and Their Molecular Bases

“…Patients suffering from major neurodegenerative diseases including stroke, Alzheimer's and Parkinson's disease are commonly diagnosed with osteoporosis, resulting in high morbidity and mortality [58][59][60]. First, ischemic or hemorrhagic stroke leads to cell death and breakdown of the blood-brain barrier (BBB) [61].…”

Myeloid Cells As a Promising Target for Brain–Bone Degenerative Diseases from a Metabolic Point of View

“…[ 3–6 ] On the other hand, osteoporosis contributes to higher morbidity and mortality in neurodegenerative diseases, as reported in several clinical studies. [ 7,8 ] Therefore, medical intervention that simultaneously ameliorates these two concomitant aging‐related diseases is urgently needed. Early studies established that brain and bone physiologically affect each other mainly through endocrine mechanisms.…”