Hip fractures are preventable: a proposal for osteoporosis screening and fall prevention in older people
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AbstractOsteoporosis is highly prevalent but underdiagnosed and undertreated in Hong Kong. Fragility fractures associated with osteoporosis often result in loss of independence and increased mortality for home-dwelling patients, imposing a high socioeconomic burden on society. This issue requires urgent attention given the rapid growth of the elderly population in Hong Kong by approximately 4.3% each year. To address this situation, a group of experts convened to discuss practical ways to reduce the burden of fractures and formulated three recommendations: first, all men (aged >= 70 years) and women (aged >= 65 years) should receive universal dual-energy X-ray absorptiometry assessment for osteoporosis. Second, all men (aged >= 70 years) and women (aged >= 65 years) with a fracture-risk assessment-derived 10-year risk (hip fracture with bone mineral density) >= 3% should receive >= 3 years of anti-osteoporotic treatment. Third, comprehensive structured assessment (including dual-energy X-ray absorptiometry) should be conducted in older patients with a history of falling. By implementing these recommendations, we estimate that we could prevent 5234 hip fractures in 10 years, an annual incidence reduction of approximately 7%, and save HK$425 million in direct medical costs plus substantial indirect savings. Ample clinical and cost-effectiveness data support these recommendations, and studies in Hong Kong and abroad could serve as models on how to implement them. We are confident that by applying these recommendations rigorously and systematically, a significant reduction in hip fractures in Hong Kong is achievable.
Acceptance Date01/06/2020
All Author(s) ListKwok TCY, Law SW, Leung EMF, Choy DTK, Lam PMS, Leung JCS, Wong SH, Ip TP, Cheung CL
Journal nameHong Kong Medical Journal
Year2020
Month6
Volume Number26
Issue Number3
PublisherHONG KONG ACAD MEDICINE PRESS
Pages227 - 235
ISSN1024-2708
LanguagesEnglish-United Kingdom
KeywordsCHINESE WOMEN, DISEASE MANAGEMENT, RECURRENT FALLS, RISK-FACTORS, HONG-KONG, BONE, ALENDRONATE, COMMUNITY, MEN, BMD
Web of Science Subject CategoriesMedicine, General & Internal;General & Internal Medicine

Last updated on 2020-28-11 at 00:07