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Undertreatment of osteoporosis in persons with dementia? A population-based study

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Abstract

Summary

In this population-based study of more than 2,600 elderly, people with dementia received less preventive treatment for osteoporosis compared to people without dementia, although osteoporotic fractures were more common in patients with dementia. Thus, our results indicate an undertreatment of osteoporosis in dementia.

Introduction

This study compares the use of osteoporosis drugs in elderly with and without dementia, taking into account osteoporotic fractures and type of housing.

Methods

We analyzed data from the baseline examination (2001–2004) of The Swedish National Study on Aging and Care- Kungsholmen (SNAC-K), Stockholm, Sweden. Participants were aged ≥66 years (n = 2610). We analysed the use of bisphosphonates, raloxifene, and calcium/vitamin D combinations in relation to clinically based dementia diagnosis. Information about osteoporotic fractures during the previous 4 years was obtained from the Swedish National Patient Register. We used logistic regression to analyze the association between dementia status and use of osteoporosis drugs.

Results

Osteoporosis drugs (mainly calcium/vitamin D combinations) were used by 5% of the persons with dementia and 12% of the persons without dementia. Furthermore, 25% of the persons with dementia and 7% of the persons without dementia had had at least one osteoporotic fracture during the past 4 years. After controlling for age, sex, osteoporotic fractures, and type of housing (own home or institution), persons with dementia were less likely to use osteoporosis drugs than persons without dementia (OR = 0.34; 95% CI, 0.19–0.59).

Conclusions

Our results indicate an undertreatment of osteoporosis in persons with dementia, although osteoporotic fractures are common among these patients.

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Acknowledgments

The Swedish National study on Aging and Care, SNAC, (http://www.snac.org) is financially supported by the Ministry of Health and Social Affairs, Sweden and the participating county councils, municipalities, and university departments. We are grateful to the participants, the participating counties, and municipalities. We want to thank the members of the SNAC-K Project Study Group for data collection and collaboration. We also wish to thank Associate Professor Ingemar Kåreholt for statistical advice. This study was supported by grants from the Swedish Research Council, the Swedish Council for Working Life and Social Research, and Karolinska Institutet KID-grant.

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Authors and Affiliations

  1. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Gävlegatan 16, 113 30, Stockholm, Sweden

    Y. Haasum, J. Fastbom, L. Fratiglioni & K. Johnell

  2. Stockholm Gerontology Research Center, Stockholm, Sweden

    Y. Haasum, J. Fastbom, L. Fratiglioni & K. Johnell

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  1. Y. Haasum
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Correspondence to Y. Haasum.

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Haasum, Y., Fastbom, J., Fratiglioni, L. et al. Undertreatment of osteoporosis in persons with dementia? A population-based study. Osteoporos Int 23, 1061–1068 (2012). https://doi.org/10.1007/s00198-011-1636-8

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  • DOI: https://doi.org/10.1007/s00198-011-1636-8

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