Disparities in the Diagnosis and Treatment of Osteoporosis in Persons with Cognitive Impairment and Dementia.

IF 5.3 2区 医学
Pritee Shrestha, Brinda Basida, Rachel E Elam, Joanna El Hajj, Brian Le, Howard A Fink, Monique Bethel, Shafer G Tharrington, Laura D Carbone
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Abstract

Purpose of review: The purpose of this review is to summarize recently published scientific evidence (from January 1, 2020-January 1, 2025), on disparities in the diagnosis and treatment of osteoporosis and the treatment of fragility fractures in persons with cognitive impairment and dementia.

Recent findings: Worldwide, the population is aging, and coincident with this, the number of individuals with osteoporosis and dementia is rapidly increasing. Several reports have suggested a link between these two chronic conditions. Persons with dementia who sustain an osteoporotic fracture have excess morbidity and mortality compared to similarly aged populations without cognitive impairment. However, the extent to which these differences are a function of disparities in the diagnosis and treatment of osteoporosis and treatment and rehabilitation for osteoporotic fractures is not clear. In this summary, we review the evidence that health and health care disparities exist for older adults with cognitive impairment or dementia with respect to osteoporosis diagnosis and treatment and management of fragility fractures. We highlight unique considerations for persons with cognitive impairment or dementia relative to diagnosis of osteoporosis, choice and frequency of use of osteoporosis pharmacotherapies, and consideration for rehabilitation services post hip fracture. More research is necessary to determine how best to reduce health care disparities with respect to diagnosis and treatment of osteoporosis and fragility fractures in older adults with cognitive impairment or dementia. Considerations should include early identification of persons at risk for fracture, use of osteoporosis drug therapies that require less frequent dosing and are administered by clinicians to enhance adherence, and access to patient and family-centered rehabilitation post hip fracture.

认知障碍和痴呆患者骨质疏松症的诊断和治疗差异。
综述目的:本综述的目的是总结近期发表的科学证据(从2020年1月1日至2025年1月1日),关于认知障碍和痴呆患者骨质疏松症的诊断和治疗差异以及脆性骨折的治疗。最近的研究发现:在世界范围内,人口正在老龄化,与此同时,患有骨质疏松症和痴呆症的人数正在迅速增加。一些报告表明这两种慢性疾病之间存在联系。患有骨质疏松性骨折的痴呆症患者与没有认知障碍的年龄相仿的人群相比,发病率和死亡率更高。然而,这些差异在多大程度上是骨质疏松症的诊断和治疗以及骨质疏松性骨折的治疗和康复差异的作用尚不清楚。在这篇综述中,我们回顾了认知障碍或痴呆老年人在骨质疏松症诊断、治疗和脆性骨折管理方面存在的健康和保健差异的证据。我们强调了与骨质疏松症的诊断、骨质疏松症药物治疗的选择和使用频率以及髋部骨折后康复服务相关的认知障碍或痴呆患者的独特考虑。需要更多的研究来确定如何最好地减少老年认知障碍或痴呆患者骨质疏松症和脆性骨折的诊断和治疗方面的医疗保健差距。考虑因素应包括早期识别有骨折风险的人,使用不需要频繁给药的骨质疏松药物治疗,并由临床医生管理以提高依从性,以及获得以患者和家庭为中心的髋部骨折后康复。
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来源期刊
Current Osteoporosis Reports
Current Osteoporosis Reports ENDOCRINOLOGY & METABOLISM-
CiteScore
8.40
自引率
2.30%
发文量
44
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of osteoporosis. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as current and future therapeutics, epidemiology and pathophysiology, and evaluation and management. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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