Archives of Osteoporosis最新文献

{"title":"Weight-bearing exercise intensity and physiotherapy outcomes in older Nigerian women with osteoporosis: a multicenter a cross-sectional study","authors":"Uchenna Cosmas Ugwu,&nbsp;Agatha Nneka Obayi,&nbsp;Olive Oluchukwu Ilo,&nbsp;Fabian Chibunine Ugwueze,&nbsp;Osmond Chukwuemeka Ene","doi":"10.1007/s11657-026-01753-2","DOIUrl":"10.1007/s11657-026-01753-2","url":null,"abstract":"<div><h3>Summary</h3><p>Weight-bearing exercise intensity in older Nigerian women with osteoporosis was mainly determined by age, not sociodemographic factors. Higher intensity was associated with better physiotherapy outcomes, highlighting the need for age-targeted rehabilitation strategies to improve bone health outcomes.</p><h3>Purpose</h3><p>This study examined the association between weight-bearing exercise intensity and physiotherapy outcomes and identified associated factors of high-intensity exercise among older Nigerian women with osteoporosis.</p><h3>Methods</h3><p>A multicenter cross-sectional study was conducted in 18 physiotherapy clinics across Nigeria (April 2025–March 2026). Women aged ≥ 50 years with clinically confirmed osteoporosis (<i>n</i> = 447) were recruited using multistage sampling. Data were collected using a structured interviewer-administered questionnaire (WBI-OQ) incorporating validated physical activity instruments (BPAQ, IPAQ). The primary outcome was physiotherapy satisfaction (satisfied vs dissatisfied). The exposure variable was weight-bearing exercise intensity (high vs low). Sociodemographic and clinical variables were assessed as covariates. Associations were tested using chi-square analysis and binary logistic regression (<i>p</i> &lt; 0.05).</p><h3>Results</h3><p>Mean age was 58.7 years; 57.1% engaged in high-intensity weight-bearing exercise and 76.7% reported satisfaction with physiotherapy. Age was the only independent predictor of exercise intensity. Women aged 55–59 years had higher odds of engaging in high-intensity exercise compared with those aged ≥ 60 years (OR = 2.33; 95% CI: 1.44–3.78; <i>p</i> &lt; 0.01). A borderline association was observed for ages 50–54 years (OR = 1.74; 95% CI: 1.00–3.04). No significant associations were found for education, occupation, marital status, or parity.</p><h3>Conclusion</h3><p>Higher weight-bearing exercise intensity was moderately prevalent but not strongly influenced by sociodemographic factors. Age was the dominant determinant of exercise intensity. Findings highlight the need for age-targeted physiotherapy strategies to optimize osteogenic exercise engagement in older women with osteoporosis.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148676921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The hidden fracture: a retrospective study of fragility vertebral fracture in patients with hip fracture","authors":"Inês Genrinho,&nbsp;Cátia Machado,&nbsp;Alina Humenyuk,&nbsp;Nuno Pais,&nbsp;Anabela Barcelos","doi":"10.1007/s11657-026-01742-5","DOIUrl":"10.1007/s11657-026-01742-5","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Vertebral fragility fractures (VFFs) are underdiagnosed despite increasing future fracture risk. In 307 hip fragility fracture patients, 28.0% had prior radiological VFFs—mostly severe, lumbar, and wedge-type—yet only 11.6% were diagnosed. This under-recognition underscores the importance of early VFFs detection to improve outcomes and prevent further fragility fractures.</p><h3>Purpose</h3><p>Vertebral fragility fractures (VFFs) are the most common osteoporotic fractures but are often undiagnosed. Despite the frequent absence of pain, VFFs are linked to increased morbidity and a higher risk of future fractures, including hip fractures. The purpose of this study was to determine the prevalence, location, type, and severity of previous VFFs in patients presenting with hip fragility fractures.</p><h3>Methods</h3><p>We conducted a retrospective study of patients aged ≥ 50 years with hip fragility fractures admitted to our FLS between 2019 and 2023. Inclusion criteria required the availability of thoracic and/or lumbar spine imaging performed within the previous five years. Clinical data, lifestyle factors, and FRAX scores were collected. Spine images were independently assessed by two blinded reviewers using <i>Genant’s</i> semiquantitative method.</p><h3>Results</h3><p>Of 357 patients screened, 307 met inclusion criteria. The mean age was 80.9 ± 9.1 years, and 84.0% were women. Radiological VFFs were present in 28.0% of patients, yet only 11.6% had a prior diagnosis. The lumbar (41.9%) and thoracic spine (31.4%) were the most frequently affected regions. Wedge-type fractures were most common (72.9%), and 62.8% were classified as severe. Patients with VFFs were significantly older (<i>p</i> = 0.007) and had higher FRAX scores (<i>p</i> &lt; 0.001). The odds of having VFFs were 2.17 and 2.07 times higher in patients with previous fractures and in those receiving antidepressant therapy, respectively.</p><h3>Conclusions</h3><p>Over one-fourth of patients with hip fractures have previous VFFs, though only a small portion have been officially diagnosed. These findings underscore the high prevalence and frequent under-recognition of VFFs.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-based osteoporosis prescreening using FRAX and portable pulse-echo ultrasound: a pilot study from Western Austria","authors":"Armin Stegmayr,&nbsp;Natalia Mach,&nbsp;Heide-Maria Preuer,&nbsp;Andreas Huber,&nbsp;Martina Prokopetz","doi":"10.1007/s11657-026-01738-1","DOIUrl":"10.1007/s11657-026-01738-1","url":null,"abstract":"<div><h3>Summary</h3><p>A community-based prescreening approach using the Austrian FRAX® model and portable pulse-echo ultrasound identified a substantial proportion of adults with findings that may warrant further osteoporosis evaluation. Our results suggest that local prescreening pathways could support earlier identification and referral, particularly in women.</p><h3>Purpose</h3><p>Early identification of adults at increased osteoporosis risk remains challenging. We evaluated a community-based prescreening approach using Austrian FRAX® and portable pulse-echo ultrasound in adults from Tyrol, Western Austria.</p><h3>Methods</h3><p>Adults aged 50–90 years voluntarily attended free community screening events. Participants completed the Austrian FRAX questionnaire and underwent tibial pulse-echo ultrasound (Bindex®), from which the density index (DI) was derived. FRAX probabilities were categorized using updated Austrian thresholds, and DI was classified as green (&gt; 0.844), yellow (0.779–0.844), or red (&lt; 0.779). Combined FRAX and DI classifications were used to describe the burden and distribution of findings relevant to further osteoporosis assessment.</p><h3>Results</h3><p>A total of 664 adults participated. Women had higher FRAX-estimated fracture probabilities and lower DI values than men. Median 10-year major osteoporotic fracture probability was 6.6% in women and 4.6% in men, and median hip fracture probability was 1.2% and 0.8%, respectively. DI was in the green range in 54.4% of women and 92.9% of men. When FRAX and DI were combined, 30.2% of women had abnormal DI despite FRAX probabilities below Austrian intervention thresholds, whereas discordance was uncommon in men.</p><h3>Conclusion</h3><p>Community-based prescreening identified a substantial number of adults who may benefit from formal osteoporosis assessment. In a region with high fracture burden and persistent care gaps, such local pathways could support earlier identification of osteoporosis risk.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excess mortality up to 7 years after low-trauma hip fracture in the largest urban region in Romania","authors":"Ramona Dobre,&nbsp;Cristina Capatina,&nbsp;Iulia Florentina Burcea,&nbsp;Catalin Cirstoiu,&nbsp;Cosmin Baciu,&nbsp;Catalina Poiana","doi":"10.1007/s11657-026-01736-3","DOIUrl":"10.1007/s11657-026-01736-3","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Hip fracture is the most severe complication of osteoporosis. We followed up patients with hip fracture for up to 7 years. Compared with the general population, the overall mortality rate ratio was approximately 9.27 over the follow-up period. Our findings justify the need for urgent improvement of osteoporosis and hip-fracture care.</p><h3>Introduction</h3><p>Hip fracture is the most severe complication of osteoporosis, being associated with substantial morbidity, loss of independence, and increased long-term mortality. Data on excess mortality after hip fracture in the population from Eastern Europe is very limited. The objective of the study is to quantify excess mortality after hip fracture by comparing observed with expected mortality derived from age-specific population data for the largest urban region in Romania.</p><h3>Methods</h3><p>We performed a longitudinal observational cohort study including patients hospitalized with hip fracture followed longitudinally up to 7 years after the fracture.</p><h3>Results</h3><p>A total of 1977 hip fracture patients (1452 women) aged ≥ 40 years were included. Between 2018 and 2024, 1460 deaths occurred (overall mortality 73.85); the overall crude mortality rate in the cohort was 215.6 per 1000 person-years. Compared with the general population, the overall age-specific mortality rate ratio (RR) was approximately 9.27 over the follow-up period. Cohort crude mortality rates were highest in the first post-fracture year and then decreased but remained elevated all across follow-up with overall annual cohort-to-population RRs of 5.74 to 18.10. In univariate Cox regression analyses, female sex was associated with a lower risk of mortality (HR 0.84, 95% CI 0.75–0.94, <i>p</i> = 0.002), while conservative management was associated with a markedly increased risk of death compared with surgical treatment (HR 1.95, 95% CI 1.72–2.21, <i>p</i> &lt; 0.001). In multivariate Cox proportional hazards analysis, conservative management remained independently associated with an increased risk of all-cause mortality (HR 2.01, 95% CI 1.77–2.28, <i>p</i> &lt; 0.001), female sex remains independently associated with improved survival (HR 0.67, 95% CI 0.60–0.76, <i>p</i> &lt; 0.001), and also increasing age is a strong independent predictor of mortality (HR 1.33, 95% CI 1.28–1.37, <i>p</i> &lt; 0.001).</p><h3>Conclusions</h3><p>Hip fracture is associated with a high and lasting mortality burden in Romanian patients. These findings justify the need for urgent improvement of osteoporosis care and hip fracture systems, aiming to improve survival and quality of life for this patient population.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-026-01736-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148615166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between post-discharge destination and osteoporosis medication use after acute-care hospital discharge for hip fracture: a population-based cohort study","authors":"Seung Hoon Kim,&nbsp;Eunjeong Choi,&nbsp;Yonghan Cha,&nbsp;Seoyeong Choi,&nbsp;Suk-Yong Jang","doi":"10.1007/s11657-026-01743-4","DOIUrl":"10.1007/s11657-026-01743-4","url":null,"abstract":"<div><h3>\u0000 <i>Summary</i>\u0000 </h3><p>Post-discharge destination was associated with differences in osteoporosis medication use after hip fracture. Discharge to long-term care facilities or home with long-term care services was associated with lower medication use. Prior treatment history was associated with differences in subgroup-specific estimates among community-dwelling patients, although formal interaction testing was not statistically significant.</p><h3>Background</h3><p>Post-discharge destination may influence osteoporosis care after hip fracture, but evidence is limited.</p><h3>Methods</h3><p>Using the National Health Insurance Service–Senior cohort in South Korea, we identified patients aged ≥ 60 years who underwent surgical treatment for incident hip fracture between 2005 and 2017. Post-discharge destination at 30 days was categorized as home without LTC services, home with LTC services, hospital, or LTC facility. The primary outcome was any osteoporosis medication use within 1 year after discharge from an acute-care hospital, defined as at least one prescription during follow-up. Incidence rates were calculated, and adjusted hazard ratios (aHRs) were estimated using Cox proportional hazards models, with stratified analyses according to prior osteoporosis medication use.</p><h3>Results</h3><p>Among 12,226 patients, osteoporosis medication use within 1 year differed significantly by post-discharge destination. Compared with patients discharged home without LTC services, those discharged to LTC facilities (aHR, 0.61; 95% CI, 0.50–0.76) and home with LTC services (aHR, 0.84; 95% CI, 0.73–0.97) were associated with a lower hazard of receiving osteoporosis medication. In stratified analyses, discharge to LTC facilities was consistently associated with lower medication use across subgroups defined by prior treatment history. Among patients discharged home with LTC services, lower medication use was observed primarily among treatment-naïve patients, whereas this pattern was less apparent among those with prior medication use; however, formal interaction testing was not statistically significant.</p><h3>Conclusions</h3><p>Osteoporosis medication use after hip fracture was associated with differences according to post-discharge destination. Lower medication use was observed among patients discharged to LTC facilities and, to a lesser extent, among those receiving home-based LTC services. These findings should be interpreted with caution, as some of the lower use in LTC settings may reflect appropriate clinical decision-making in the context of competing care priorities or limited life expectancy.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148614670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypercalcemia unmasks a PTHrP-secreting liver metastasis in papillary thyroid carcinoma","authors":"Jing-Huan Liao,&nbsp;Chih-Wei Yang,&nbsp;Yu-Chen Hsieh,&nbsp;Yu-Juei Hsu,&nbsp;Shun-Neng Hsu","doi":"10.1007/s11657-026-01735-4","DOIUrl":"10.1007/s11657-026-01735-4","url":null,"abstract":"","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of fracture-derived polygenic scores with FRAX for fracture risk prediction in postmenopausal women","authors":"Anqi Liu,&nbsp;Jianing Liu,&nbsp;Qing Wu","doi":"10.1007/s11657-026-01740-7","DOIUrl":"10.1007/s11657-026-01740-7","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;\u0000 &lt;i&gt;Summary&lt;/i&gt;\u0000 &lt;/h3&gt;&lt;p&gt;We evaluated whether adding a genetic risk score derived from forearm fracture improves fracture prediction beyond standard clinical tools. Incorporation of GPS resulted in a small increase in time-dependent AUC, with improvement in NRI. Decision curve analysis suggested potential clinical benefit across certain threshold ranges.&lt;/p&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Previous studies have incorporated estimated bone mineral density (eBMD)-derived polygenic scores into FRAX to improve fracture risk prediction, indirectly capturing genetic susceptibility through bone mineral density. However, the genetic architectures of fracture and BMD only partially overlap, suggesting that fracture-specific genetic risk may provide complementary and more direct biological information. With the availability of recently released forearm fracture GWAS summary statistics, we developed Bayesian genome-wide polygenic scores (GPS) derived from fracture risk and evaluated whether integrating fracture-derived Bayesian GPS into FRAX could enhance clinical fracture risk prediction.&lt;/p&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;We constructed two Bayesian GPS using recently released UK Biobank forearm fracture GWAS summary statistics (GWAS Catalog study ID: GCST90281273) with two Bayesian frameworks: polygenic risk score-continuous shrinkage (PRS-CS) and summary-data-based Bayesian regression with continuous shrinkage and functional annotation integration (SBayesRC). The fracture-derived Bayesian GPS were integrated into FRAX to derive fracture-specific GPS-FRAX models. Model performance was evaluated in 10,135 postmenopausal women from the Women’s Health Initiative (WHI) using time-dependent area under the receiver operating characteristic curve (AUC), Brier score, net reclassification improvement (NRI), calibration analysis, and decision curve analysis (DCA).&lt;/p&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;Compared with the FRAX-CRF model (time-dependent AUC = 0.683), fracture-derived Bayesian GPS-FRAX models demonstrated modest improvements in discrimination, with time-dependent AUCs of 0.693 for PRS-CS and 0.690 for SBayesRC. Overall reclassification proportions were low (1.58% for SBayesRC and 1.82% for PRS-CS), but NRI was significantly improved, with overall NRI estimates of 2.20% (95% CI, 0.83 to 3.58%) for SBayesRC and 2.72% (95% CI, 1.34 to 4.19%) for PRS-CS. These findings indicate incremental predictive gain beyond clinical FRAX factors despite modest increases in discrimination.&lt;/p&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Incorporation of fracture-derived Bayesian GPS into FRAX resulted in a modest but statistically significant improvement in model discrimination, as reflected by a small increase in AUC. In addition, improvements in NRI and higher estimated net benefit in decision curve analysis suggest incremental clinical utility. However, the overall magnitude of improvement remained limited, indicating that the added predictive value beyond established ","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11657-026-01740-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The osteoporosis care cascade in postmenopausal women with and without cardiovascular disease: a nationally representative cross-sectional study using dual-energy X-ray absorptiometry","authors":"Deuk Hee Choi,&nbsp;Je Il Ryu","doi":"10.1007/s11657-026-01737-2","DOIUrl":"10.1007/s11657-026-01737-2","url":null,"abstract":"<div><h3>Summary</h3><p>No study has used measured bone mineral density (BMD) data to compare osteoporosis care gaps between women with and without cardiovascular disease. Among 5,420 postmenopausal women with dual-energy X-ray absorptiometry (DXA), 71.1% with osteoporosis were undiagnosed and 87.2% untreated; cardiovascular disease history did not narrow these care gaps.</p><h3>Purpose</h3><p>No population-based study has used measured bone mineral density (BMD) data to compare the osteoporosis care cascade between women with and without cardiovascular disease (CVD). This study quantified the dual-energy X-ray absorptiometry (DXA)-based care cascade in South Korean postmenopausal women and tested whether CVD history is associated with care gaps.</p><h3>Methods</h3><p>Data were from the Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2011 (<i>n</i> = 5,420 women aged ≥50 years with valid DXA). Osteoporosis was defined as a minimum T-score ≤ −2.5. CVD was defined as self-reported physician-diagnosed stroke, myocardial infarction, or angina pectoris. Multivariable logistic regression identified predictors of unawareness and non-treatment.</p><h3>Results</h3><p>Of 5,420 women, 1,957 had DXA-confirmed osteoporosis (weighted prevalence, 34.0%); weighted awareness was 28.9% and treatment 12.8%. Awareness (35.7% vs. 28.4%, <i>p</i> = 0.084) and treatment (16.5% vs. 12.6%, <i>p</i> = 0.238) did not differ between CVD and non-CVD groups. After adjustment, CVD history was not associated with unawareness (odds ratio [OR] 0.76; 95% confidence interval [CI] 0.51–1.12; <i>p</i> = 0.162) or non-treatment (OR 0.79; 95% CI 0.46–1.37; <i>p</i> = 0.403). Dyslipidemia was independently linked to lower odds of both unawareness and non-treatment.\u0000</p><h3>Conclusion</h3><p>In this cohort, 71.1% of women with T-score ≤ −2.5 had no prior physician diagnosis of osteoporosis, and only 12.8% were on medication. The CVD and non-CVD groups did not differ in awareness or treatment rates, suggesting that cardiovascular follow-up does not facilitate osteoporosis detection.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of an mHealth adoption questionnaire for osteoporosis management in Iranian older adults at risk","authors":"Golaleh Karbasi,&nbsp;Siti Anom Ahmad,&nbsp;Ghobad Moradi,&nbsp;Mahmoud Danaee,&nbsp;Nur Hafidah Ishak,&nbsp;Puvaneswaran Kunasekaran,&nbsp;Mohd Nazim Mohtar","doi":"10.1007/s11657-026-01741-6","DOIUrl":"10.1007/s11657-026-01741-6","url":null,"abstract":"<div><h3>Background</h3><p>With the increasing prevalence of osteoporosis among older adults and the growing need for effective self-management strategies, mobile health (mHealth) technologies may play an important role in supporting osteoporosis management. This study aimed to adapt and validate a culturally appropriate Persian questionnaire to assess mHealth adoption for osteoporosis management among Iranian adults aged ≥50 years, regardless of osteoporosis diagnosis status.</p><h3>Methods</h3><p>A questionnaire was adapted from established theoretical frameworks, including the Unified Theory of Acceptance and Use of Technology (UTAUT), the Health Belief Model (HBM), self-efficacy, digital literacy, and technology anxiety. The instrument underwent cross-cultural adaptation and psychometric evaluation in two phases: (1) content validation and cognitive testing, and (2) construct validation using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with SmartPLS version 4.</p><h3>Results</h3><p>The final instrument consisted of 54 items after removing poorly performing indicators. The measurement model demonstrated satisfactory psychometric properties, with average variance extracted (AVE) values ranging from 0.608 to 0.833 and composite reliability (CR) values between 0.866 and 0.950. Discriminant validity was supported by heterotrait–monotrait ratio (HTMT) values below the recommended threshold. Performance expectancy, self-efficacy, digital literacy, and perceived severity emerged as key determinants of mHealth adoption among older adults.</p><h3>Conclusion</h3><p>This study developed a culturally adapted Persian questionnaire with strong reliability and validity for assessing mHealth adoption in osteoporosis management among older adults. The instrument may help researchers, clinicians, and policymakers identify barriers to digital health engagement and design targeted interventions to improve mHealth adoption in ageing populations.</p><h3>\u0000 <i>Summary</i>\u0000 </h3><p>The study designed and validated a culturally appropriate questionnaire to assess the acceptance of mHealth for osteoporosis management in Iranian adults over 50. Key predictors included performance expectancy, self-efficacy, and digital literacy. The findings support implementing tailored interventions to increase mHealth acceptance among older adults in resource-limited settings.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report and medication implications: bilateral atypical femoral fractures in a patient with long-term bisphosphonate use after breast cancer surgery","authors":"Jiahui Liu,&nbsp;Xi Zhu,&nbsp;Zhenguo Liu,&nbsp;Ruiyu Li","doi":"10.1007/s11657-026-01746-1","DOIUrl":"10.1007/s11657-026-01746-1","url":null,"abstract":"<div><h3>Background</h3><p>The incidence of atypical femoral fractures in breast cancer patients is theoretically expected to be significantly higher than in those with primary osteoporosis. This is due to the prolonged and higher dosages of bisphosphonates used for post-operative bone protection and secondary osteoporosis. However, there is a notable lack of literature addressing this issue. Diagnosing and managing atypical femoral fractures in breast cancer patients presents unique challenges that differ substantially from those encountered in osteoporosis patients.</p><h3>Case presentation</h3><p>We present a 58-year-old postmenopausal woman with a history of breast cancer who reported bilateral mid-thigh pain. From June 2015 to January 2017, she received zoledronic acid (4 mg) intravenously every 3 months, totaling seven doses. From 2017 to 2021, her regimen changed to a 4 mg infusion every 6 months, resulting in ten doses during this period. Overall, she underwent 17 zoledronic acid infusions over approximately 5.5 years. After minor trauma, she suffered sequential bilateral femoral shaft fractures. Bone metastases were initially suspected but ruled out through histopathological examination of both fracture sites, which showed no malignancy. Following her last infusion in June 2024, a multidisciplinary team (MDT) discussion was held. Considering her prolonged bisphosphonate exposure, the fracture sites, and imaging consistent with the 2013 American Society for Bone and Mineral Research (ASBMR) criteria, she was diagnosed with bisphosphonate-related atypical bilateral femoral fractures. Zoledronic acid was discontinued, and teriparatide treatment began, leading to significant pain relief, improved mobility, and radiological evidence of fracture healing after 9 months. However, due to mildly elevated tumor markers (CA19-9 and neuron-specific enolase [NSE]), teriparatide was switched to denosumab, which led to a prompt recurrence of bilateral thigh pain.</p><h3>Conclusion</h3><p>This case underscores the critical importance of early and differential diagnosis of atypical femoral fractures in this patient population. The findings suggest that teriparatide can be effective in promoting atypical femoral fracture healing; however, its use in patients with a history of cancer remains controversial and requires individualized risk-benefit assessment under multidisciplinary guidance. Furthermore, switching to denosumab during active fracture healing may lead to symptomatic recurrence. This approach might also be relevant for patients with primary osteoporosis. Multidisciplinary management and long-term monitoring are crucial for managing such complex cases.</p></div>","PeriodicalId":8283,"journal":{"name":"Archives of Osteoporosis","volume":"21 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}