Prevention of Osteoporotic Fractures in Residential Aged Care: Updated Consensus Recommendations

Gustavo Duque; Sandra Iuliano; Jacqueline C T Close; Mizhgan Fatima; Kirtan Ganda; Stefanie Bird; Ben Kirk; Mary Levidiotis; Catherine M Said; Alexandra Papaioannou; Charles A Inderjeeth

doi:10.1016/j.jamda.2021.12.041

Prevention of Osteoporotic Fractures in Residential Aged Care: Updated Consensus Recommendations

J Am Med Dir Assoc. 2022 May;23(5):756-763. doi: 10.1016/j.jamda.2021.12.041. Epub 2022 Jan 21.

Affiliations

¹ Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia; Department of Medicine-Western Health, The University of Melbourne, St. Albans, Victoria, Australia. Electronic address: gustavo.duque@unimelb.edu.au.
² Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia; Department of Medicine-Western Health, The University of Melbourne, St. Albans, Victoria, Australia.
³ Neuroscience Research Australia, University of New South Wales, Randwick, New South Wales, Australia.
⁴ Concord Clinical School, The University of Sydney, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
⁵ Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St. Albans, Victoria, Australia; Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia; Department of Physiotherapy, Western Health, St Albans, Victoria, Australia.
⁶ GERAS Center, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
⁷ Area Rehabilitation and Aged Care NMHS and University of Western Australia, Perth, Western Australia, Australia.

PMID: 35074360
DOI: 10.1016/j.jamda.2021.12.041

Abstract

Osteoporosis is underdiagnosed and undertreated in people living in Residential Aged Care Facilities (RACFs), even though aged-care residents are at greater risk of experiencing fractures than their community-dwelling counterparts. The first (2009) and second (2016) Consensus Conferences on the Treatment of Osteoporosis in RACFs in Australia addressed the prevention of falls and fractures in RACFs. A third Consensus Conference was held to review advances in the field of osteoporosis for people living in RACFs and to update current guidelines. The Conference was held virtually in October 2020 due to the COVID-19 pandemic. Attendance at the meeting was open to health practitioners (n = 116) (eg, general practitioners, geriatricians, rehabilitation specialists, endocrinologists, pharmacists, and physiotherapists) working in RACFs. Participants chose and/or were assigned to breakout groups to review the evidence and reach a consensus on the topic area assigned to the group, which was then presented to the entire group by a nominated spokesperson. Recommendations developed by breakout groups were discussed and voted on by all attending participants. This article updates the evidence for preventing falls and fractures and managing osteoporosis in older adults living in RACFs based on agreed outcomes from the group. We anticipate these updated recommendations will provide health practitioners with valuable guidance when practicing in RACFs.

Keywords: Osteoporosis; anabolics; antiresorptives; falls; fractures; nursing homes; vitamin D.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Assisted Living Facilities*
COVID-19*
Humans
Osteoporosis* / prevention & control
Osteoporotic Fractures* / epidemiology
Osteoporotic Fractures* / prevention & control
Pandemics