Prevention and care of osteoporosis
Jennifer Stobbart, Prof. Nick Bosanquet
Imperial College London
Background
It is well-documented that osteoporosis-related fractures can have serious implications for both the health and quality of life of those who suffer the condition, so much research is carried out into preventing the development of this disease. However, it must be remembered that this disease is not only relevant for the typical elderly patient. Other groups at risk include disabled young adults. The aim of this study is to assess how at risk this group is, how protected it is, and how well those who already suffer the disease are cared for. This will lead to the development of guidelines for providing the best care in this setting.
Methods
12 service-users (4f:8m, age 20-66) resident at a Sussex Health Partnership home were recruited to this study into the prevention and care of osteoporosis. All service-users are dependent adults with complex physical and developmental disabilities, ranging from epilepsy and birth asphyxia brain injuries, to genetic conditions such as Downs syndrome and Rett syndrome. Literature searches were completed into risk and protective factors for developing osteoporosis. Some risk factors are particularly relevant for this group, such as: being fed via a PEG tube, certain drugs (such as anticonvulsants), and the inability to participate in weight-bearing exercise. Protective factors for osteoporosis include: vitamin D and calcium dietary supplementation, bisphosphonate medication, and weight-bearing exercise. Conventional and approved methods of monitoring bone mineral density and diagnosing osteoporosis include bone profile blood tests and dual energy x-ray absorptiometry (DEXA) scans. Information on the residents' risk factors, protective factors and investigations was gathered between January and April 2008 by examination of nursing records (held at the home), discussion with nursing staff and dietician, questionnaire, and medical records (held at the residents' general practitioner's surgery). Examination of nursing records would also reveal whether the "flowchart", a tool designed to identify those at risk of osteoporosis, is being utilised.
Conclusions
The task remains to weigh up the risk and protective factors to create a comprehensive care plan which will identify and monitor those at risk of developing osteoporosis and ensure that those who do have osteoporosis are helped to stay free from fractures.
