Strategies for prevention of elderly hip fracture

ABSTRACT

One of the severe complications of osteoporosis is hip fracture, which can occur even with minimal trauma. This burdensome complication is closely associated with an increased risk of mortality, impairment, and decreased quality of life, resulting in enormous health care costs. Hip fracture is significantly related to a previous history of fracture, and its risk can be determined by bone strength and type of trauma-with falls posing an especially high risk. The first step to prevent osteoporotic fracture is the detection of osteoporosis, relying on the quantification of bone density via imaging techniques such as dual-energy X-ray absorptiometry and quantitative computed tomography. In addition, various preventive strategies have been introduced. Above all, proper supplementation of vitamin D, protein, milk, calcium, folic acid, vitamin B12, and vitamin K is beneficial for prevention of osteoporotic fracture for elderly patients who are susceptible to nutrition imbalance. For elderly patients, rehabilitation is considered to be crucial for increasing function and improving patients' activities of daily living as well. A fall-preventive intervention program has been known to be the effective and useful way for elderly patients to reduce fall risk, which can be assessed with the 'timed up and go' test. A home hazard modification program such as wearing anti-slip shoe devices has been proven to decrease fall risk in community-living elderly. Therefore, diagnosis of osteoporosis, proper supplementation of nutrients, rehabilitation, and a fall-preventive intervention program are essential components in the prevention of hip fracture.