Screening Prevents Hip Fractures in Older Adults -- MEDICA - World Forum for Medicine

Scientists at Johns Hopkins found that using a machine to estimate bone density by measuring the tissues' ability to absorb X-rays was associated with a 36 percent reduction in hip fractures over six years compared with usual medical care.

According to Neil Powe, M.D., M.P.H., M.B.A., director of Hopkins' Welch Center for Prevention, Epidemiology and Clinical Research, there are two approaches to help prevent osteoporosis-related fractures. One is to promote measures that can prevent the disease itself via adequate calcium and vitamin D intake, weight-bearing physical activity, and elimination of the use of tobacco and alcohol. The second approach is to test for osteoporosis to help identify people with low bone density and then plan treatment.

To assess the benefits of screening for osteoporosis, the Hopkins team studied 3,107 men and women, age 65 and older, who were participating in CHS from 1994 to 1995. Participants already diagnosed with osteoporosis or a previous hip fracture, and those taking bisphosphonate drugs were excluded. Subsequent treatment decisions were left to the participants and their doctors. The researchers followed study participants for up to six years and collected information about hip fractures by using hospital records.

The Hopkins team found that hip fractures occurred in 33 screened participants (about five fractures per 1,000 person-years) and 69 usual-care participants (about eight fractures per 1,000 person-years).

"This difference is statistically significant, but there were some other differences between the groups that can partially explain the variance in the incidence of hip fracture,” says investigator Lisa Kern. "Surprisingly, differences in prescription of vitamin D, calcium, estrogen and bisphosphonates did not account for the entire difference in hip fractures.”; Source: Johns Hopkins Medical Institutions