5 keys to fracture prevention

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Alexandra Papaionnou, MD
Alexandra Papaionnou, MD

A new guideline aims to help older adults, their families and caregivers prevent fractures in residents of senior living communities. The guideline, published in the Canadian Medical Association Journal, is consistent with recommendations from AMDA-The Society for Post-Acute and Long-Term Care Medicine, according to its authors, although osteoporosis medications differ between the two countries.

Residents of long-term care communities have a two- to four-fold risk of sustaining a fracture compared with adults of similar age living in the community, according to the authors.

"Our goal is to reduce the number of fractures and associated pain as well as to avoid transfers to hospitals to treat these injuries," Alexandra Papaioannou, MD, professor of medicine at McMaster University and lead author of the guideline, said in a statement. "Fractures reduce quality of life for people and can result in early death."

The authors offer five keys to fracture prevention that senior living professionals can keep in mind and share with residents:

  1. Calcium and vitamin D. Osteoporosis Canada recommends 1,200 mg of calcium through diet or 500 mg of a calcium supplement per day and says that vitamin D intake should be 800 to 2,000 international units a day in older adults. (The U.S.-based National Osteoporosis Foundation recommends that women aged 50 or more years and men aged 71 or more years get 1,200 mg of calcium from all sources, and it recommends 800 to 1,000 international units of vitamin D for adults aged 50 or more years.)
  2. Osteoporosis medications. Older adults should take them if they are prescribed. 
  3. Hip protectors. Older adults should wear them if indicated.
  4. Exercise. Regular strength and balance exercises can greatly reduce the risk of a debilitating fall. Weight-bearing exercise, resistance training and Tai Chi, for example, are effective ways to maintain strength and keep older adults more balanced.
  5. Individually tailored interventions. Interventions such as anti-slip shoes and walk bars, for instance, can help keep older adults safe.

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