Commentary

Be proactive in fracture prevention


 

Several studies published over the last few years have shown declining rates of diagnosis and treatment of osteoporosis in older adults. In part, this may be due to declining ability to diagnose osteoporosis because declining reimbursement for dual x-ray absorptiometry has made it less available to patients and doctors. The study by Curtis et al. from the annual meeting of the American College of Rheumatology confirms prior findings and confirmation is important in driving the message home.

More research is needed to understand the reasons why patients and health care providers are not diagnosing osteoporosis, given that we can easily do so, and not treating osteoporosis or accepting recommended treatments for osteoporosis, given that we have many effective treatments that reduce the risk of fractures, many of them very inexpensive.

The vast majority of Medicare patients have major risk factors for falls, and falls are the most important risk factor for osteoporotic fractures. It is important to be proactive, to ask about drugs and diseases than increase falls, to educate patients about how to prevent falls, and to initiate treatments that strengthen bones so that they are less likely to break as a consequence of falling.

Dr. Shane is an endocrinologist, professor of medicine, and vice chair of medicine for clinical and epidemiological research at Columbia University in New York. She had no conflicts to disclose.

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