Undertreatment of osteoporosis in persons with dementia? A population-based study

Haasum, Ylva; Fastbom, Johan; Fratiglioni, Laura; Johnell, Kristina

doi:10.1007/s00198-011-1636-8

Cited by 43 publications

(46 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings contrasted with the results of some previous studies, in which osteoporosis was not associated with increased risk of dementia (Wright 2007;Haasum et al 2012;Giangregorio et al 2009). However, these studies used a patient's medication to identify a diagnosis of osteoporosis, which could have led to the underestimation of the sample size.…”

Section: Discussioncontrasting

confidence: 99%

“…Patients with dementia are less likely to receive osteoporosis medication, such as bisphosphonates, than patients without dementia, and -if prescribed -the medication might be of low potency (Haasum et al 2012). …”

Section: Discussionmentioning

confidence: 99%

“…To avoid the underdiagnosis of osteoporosis affecting our outcome estimation, we included patients with osteoporosis fracture (ICD-9 733.1) in the study cohort (Haasum et al 2012). Study subjects with the diagnosis of osteoporosis from1996 to 1999 were excluded at the baseline to begin the identification of patients with osteoporosis newly diagnosed from 2000 to 2010.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with osteoporosis (ICD-9-CM code 733.0) and osteoporotic fracture (ICD-9-CM code 733.1) were included in the study cohort because osteoporosis is an underdiagnosed disease (Haasum et al 2012). A primary discharge diagnosis of osteoporosis was used to identify all patients diagnosed with newonset osteoporosis from 2000 to 2010.…”

Section: Study Patientsmentioning

confidence: 99%

See 3 more Smart Citations

Increased risk of dementia in patients with osteoporosis: a population-based retrospective cohort analysis

Chang

Chung

Lin

et al. 2013

AGE

View full text Add to dashboard Cite

Osteoporosis is a common systemic skeletal disease that predominantly affects people older than 50 years and often co-occurs with dementia. The purpose of this study was to evaluate the risk of dementia in osteoporosis patients in Taiwan. Using data from Taiwan's National Health Insurance Research Database (NHIRD), we identified 23,941 patients with osteoporosis from 2000 to 2010 and 47,579 nonosteoporosis control patients, frequency-matched for age, sex, and index year, excluding patients with dementia at the baseline. We conducted univariate and multiple Cox proportional-hazards regression analyses to calculate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of the association between osteoporosis and risk of dementia. After adjustment for potential risk factors, the osteoporosis patients exhibited 1.46-fold and 1.39-fold higher risk of dementia (95 % CI=1.37-1.56) and Alzheimer's disease (95 % CI=0.95-2.02), respectively, compared with the matched nonosteoporosis patients. We observed increased risk of dementia in both men and women with osteoporosis. The osteoporosis patients receiving bisphosphonate treatment or estrogen supplementation were associated with significantly lower risk of dementia compared with the osteoporosis patients who did not receive any treatment. Overall, our results suggest higher risks of dementia in osteoporosis patients than in nonosteoporosis patients. Osteoporosis could thus be considered an early risk factor for dementia. Future large- AGE (2014)

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Increased risk of dementia in patients with osteoporosis: a population-based retrospective cohort analysis

Chang

Chung

Lin

et al. 2013

AGE

View full text Add to dashboard Cite

show abstract

“…6 In addition to those with osteoporosis, certain other populations are at increased risk of sustaining hip fractures including those with dementia and those with a history of prior fragility fractures. 5,7,[8][9][10] dementia increases hip fracture incidence through intermediate risk factors such as falls and low bone mineral density (BMD). 9 Patients with dementia are 2.7 times more likely to sustain a hip fracture than age-and sex-matched controls without dementia.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and Treatment of Osteoporosis in High-Risk Patients Prior to Hip Fracture

Gleason

Menzies

Mendelson

et al. 2012

Geriatr Orthop Surg Rehabil

View full text Add to dashboard Cite

Purpose: Hip fractures in older adults are common and serious events. Patients who sustain fragility hip fractures are defined as having osteoporosis. Patients with dementia or a history of a prior fragility fracture are at increased risk of a future fracture. This study assesses prefracture osteoporosis diagnosis and treatment in high-risk groups. Methods: A case-control analysis of a database of all patients age !60 years admitted for surgical repair of nonpathological, low-impact femur fracture between May 2005 and October 2010 was performed. Results: Of 1070 patients, 511 (47.8%) had dementia and 435 (40.7%) had been diagnosed with osteoporosis prior to admission. Patients with dementia were more likely to have a diagnosis of osteoporosis prior to their fracture than those without dementia (43.8% vs 37.7%, P < .05). Twenty-five percent of the total study population had been treated with calcium and vitamin D (CalþD) prior to admission, and 12% with other osteoporosis medications. There was a trend toward patients with dementia being more likely to have been on CalþD prior to admission (27.6% vs 22.5%, P ¼ .06), but no difference in treatment with other agents (10.8% vs 13.1%, P ¼ .25). Patients with prior fragility fractures were more likely to be on CalþD (32.3% vs 25.0%, P < .02); however, there was no difference in the use of other osteoporosis medications (12.3% vs 12%, P ¼ .90). Conclusion: Fewer than half of patients that presented with hip fractures were diagnosed with osteoporosis prior to fracture and primary preventative treatment rates were low. Although patients with dementia are more likely to be diagnosed with osteoporosis, they were not more likely to be treated, despite having a greater risk. Additionally, those with prior fragility fractures are often not on preventative treatment. This may represent a missed opportunity for prevention and room for improvement in order to reduce osteoporotic hip fractures.

show abstract

Net costs of dementia in Sweden – An Incidence Based 10 Year Simulation Study

Sköldunger

Wimo

Johnell

2012

Int J Geriat Psychiatry

View full text Add to dashboard Cite

show abstract

Undertreatment of osteoporosis in persons with dementia? A population-based study

Abstract: Our results indicate an undertreatment of osteoporosis in persons with dementia, although osteoporotic fractures are common among these patients.

Cited by 43 publications

References 48 publications

Increased risk of dementia in patients with osteoporosis: a population-based retrospective cohort analysis

Increased risk of dementia in patients with osteoporosis: a population-based retrospective cohort analysis

Diagnosis and Treatment of Osteoporosis in High-Risk Patients Prior to Hip Fracture

Net costs of dementia in Sweden – An Incidence Based 10 Year Simulation Study

Contact Info

Product

Resources

About