Osteoporosis in patients with dementia is associated with high morbidity and mortality Findings from a single orthogeriatric unit

Background and objectives

Osteoporosis and dementia are common and associated with a high healthcare burden. The aim of this paper was to assess the impact of dementia on treatment, morbidity and mortality in osteoporosis.

Methods

Data were collected on 502 prospective orthogeriatric admissions for fracture. Fisher's exact chi-square was used to compare treatment stratified by dementia status.

Results

Of the 502 patients, 281 (56%) had osteoporosis, 226 (45%) had dementia, and 156 (31%) had dementia and osteoporosis diagnosed before they sustained fractures. Patients with dementia were more likely to have osteoporosis but less likely to be receiving treatment. Although there was a significant improvement in discharge versus admission rates of osteoporosis treatment, those with dementia were less likely to be treated with antiresorptive therapy (36%, compared with 59%, P <0.001) or combined therapy (32%, compared with 56%, P <0.001) and had double the 90-day mortality (17.3%, compared with 9.6%) and six times the 30-day mortality (6.4%, compared with 1.6%).

Discussion

Patients with dementia and osteoporosis have a higher risk of recurrent fractures and mortality. Prevention may be the key strategy.