Monday, February 12, 2018

A Perfect Storm for Broken Bones - The New York Times

A "perfect storm" threatens to derail the progress that has been made in protecting the bone health of Americans. As the population over 50 swells, fewer adults at risk of advanced bone loss and fractures are undergoing tests for bone density, resulting in a decline in the diagnosis and treatment of osteoporosis, even for people who have already broken bones.

If this trend is not reversed, and soon, by better educating people with osteoporosis and their doctors, the result could be devastating, spawning an epidemic of broken bones, medical office visits, hospital and nursing home admissions and even premature deaths.

Currently, many people at risk of a fracture — and often their doctors — are failing to properly weigh the benefits of treating fragile bones against the very rare but widely publicized hazards of bone-preserving drugs, experts say.

One serious consequence already seems to have happened: a leveling off and possible reversal in what had been a decade-and-a-half-long decline in hip fractures among postmenopausal women, according to a new study of all women on Medicare who were hospitalized with an osteoporotic hip fracture between 2001 and 2015.

The data revealed a steady decline in hip fractures among women 65 and older on Medicare to 730 per 100,000 in 2015 from 931 per 100,000 in 2002. But starting in 2012, the rate adjusted for age suddenly leveled off. Had the decline continued, an estimated 11,464 fewer women would have broken their hips between 2012 and 2015, the researchers reported in December in the journal Osteoporosis International.

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