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

Abstract

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. METHOD: 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.