Aged Care Insite Issue 114 | Aug-Sep 2019 | Page 36

clinical focus The silent disease of aged care osteoporosis. The authors suggested that this may not be an accurate figure and that osteoporosis is likely to be under- diagnosed, which severely limits treatment. One of the authors of the study, Kim Lind, a research fellow at Macquarie University, spoke with Aged Care Insite to unpack the study and its results. More can be done to prevent osteoporosis-related falls. Kim Lind interviewed by Conor Burke R esidential aged care facilities can be doing more to treat osteoporosis and can do better to prevent falls and osteoporosis-related fractures. These are the conclusions from a new study looking at anti-osteoporosis medication use in aged care. The study also found that reported diagnosis of osteoporosis in RACFs was lower than the international data, which suggests that up to 86 per cent of older adults have the disease. In the RACFs studied, only a third of residents were reported as having 32 agedcareinsite.com.au ACI: Currently, what does the literature tell us is the best course of action for osteoporosis treatment? KL: It depends on the setting. For younger adults, we know that prevention is the best course, so the best thing we can all be doing right now to prevent osteoporosis is getting enough vitamin D, getting enough calcium in our diet, and doing weight- bearing exercise – just twice a week. Then, as adults get older, if their osteoporosis gets severe enough, they will want to be taking medication. For a lot of people, that just means taking a vitamin D supplement, and if osteoporosis gets more severe, taking an antiresorptive medication, of which there are two different classes. Taking one of those medications is very effective for preventing fractures, and we hear a lot about preventing fractures because they do terrible things to people. For a lot of older adults, getting a fracture will mean losing their independence, it will mean a significant decline in their health, and for some of them it can even mean early death. It’s really important to prevent that. For people in residential aged care, which was the population we were studying, it’s especially important because they have a lot of the risk factors for falling and getting low-impact fractures. The morbidity rates among those in residential aged care with osteoporosis, and after falls, breaks and fractures, is quite high. What are you finding are the current trends of treatment in residential age care? We had a very large study. We had over 10,000 residents who were in 68 facilities across NSW and the ACT, and one of the surprising things was that we found for only about a third of residents there was osteoporosis actually recorded in their electronic health record at the facility.