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Screening for osteoporosis: a survey of older psychiatric inpatients at a tertiary referral centre

Stubbs, B., Zapata-Bravo, E. and Haw, C. (2009) Screening for osteoporosis: a survey of older psychiatric inpatients at a tertiary referral centre. International Psychogeriatrics. 21(1), pp. 180-186. 1741-203X.

Item Type: Article
Abstract: Background: Osteoporosis causes much morbidity and mortality among elderly people. Older inpatients with severe mental illness may be at particular risk of osteoporosis because of factors including immobility, vitamin D deficiency and psychotropic medication. Method: We screened predominantly older inpatients with severe mental illness for osteoporosis using a peripheral DEXA scanner. Associations were examined between patient variables and osteoporosis as detected by DEXA scan, Z-scores and history of fragility fractures. Patients were followed up to see how many subsequently received drug treatment for osteoporosis. Patient acceptability of the scanning technique was also assessed. Results: It was possible to scan 72/89 (81%) of patients. Mean T-score was -2.79 (SD 1.50) and mean Z-score -0.76 (SD 1.34). Forty-two (58%) patients had osteoporosis and 23 (32%) osteopenia. Twelve (17%) patients with a history of fragility fractures had osteoporosis on DEXA scan. A scan suggestive of osteoporosis and a history of fragility fractures were both associated with age of 75 years and over and thoracic kyphosis. Low Z-scores were associated with longer hospital stay and osteoporosis-predisposing drugs. Patient acceptability of scanning was high. At follow-up, only 7/16 (44%) patients were suitable for central scanning and 9/40 (23%) for bisphosphonates. Conclusion: Older institutional patients with severe mental illness are likely to be at high risk of developing osteoporosis. Peripheral DEXA scanning is acceptable to these patients and identifies those at high risk of fractures. Some behaviorally disturbed patients are not suitable for central scans or for some osteoporosis drug treatments.
Uncontrolled Keywords: Osteoporosis, osteopenia, screening, DEXA scan, risk factors, mental illness, older adults, bisphosphonates
Subjects: R Medicine > RC Internal medicine > RC435 Psychiatry > RC451.4 Geriatric psychiatry
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system > RC931.O73 Osteoporosis
Creators: Stubbs, B, Zapata-Bravo, E and Haw, Camilla
Publisher: Cambridge University Press
Northamptonshire and East Midlands: Health
Faculties, Divisions and Institutes: University Faculties, Divisions and Research Centres - OLD > Faculty of Health & Society > Mental Health and Learning Disability
Faculties > Faculty of Health & Society > Nursing
Date: 1 February 2009
Date Type: Publication
Page Range: pp. 180-186
Journal or Publication Title: International Psychogeriatrics
Volume: 21
Number: 1
Language: English
ISSN: 1741-203X
Status: Published / Disseminated

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