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.