Osteoporosis Screening Prevents Fractures

Investigators have determined that osteoporosis screening in individuals aged 65 and over can prevent a large percentage of hip fractures. They found that using bone densitometry screening was associated with a 36% decrease in hip fractures over a six-year-time period compared with the usual medical care.

The study, conducted by researchers at Johns Hopkins University (Baltimore, MD, USA), was published in the February 1, 2005, issue of the journal Annals of Internal Medicine. The study is a novel approach at assessing the effects of osteoporosis screening for both men and women, evaluating 3,107 individuals from the Cardiovascular Health Study (CHS). The CHS was created to establish risk factors for cardiovascular disease in older adults.

"Although some groups recommend screening for osteoporosis, no study had proven that screening prevents fractures. This study provides new evidence for the effectiveness of osteoporosis screening,” stated the lead investigator of the study, Lisa Kern, M.D., M.P.H., from Johns Hopkins University School of Medicine.

To evaluate the advantages of osteoporosis screening, the investigators assessed 3,107 men and women, aged 65 or older, who were part of the CHS from 1994 to 1995. Participants already diagnosed with osteoporosis or who had a previous hip fracture and those taking bisphosphonate drugs were excluded. The scientists discovered that hip fractures occurred in 33 screened individuals (about five fractures/1,000 person-years) and 69 usual-care participants (about eight fractures/1,000 person-years).

"This difference is statistically significant, but there were some other differences between the groups that can partially explain the variance in the incidence of hip fracture. Surprisingly, differences in prescription of vitamin D, calcium, estrogen, and bisphosphonates did not account for the entire difference in hip fractures,” said Dr. Kern.

The study did not gather data on behavioral changes, including the use of fall-preventative strategies or increased physical activity, and even though it was not randomized, the study was the best way currently to assess the effectiveness of screening, according to the researchers.




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