Clinical Interventions in Aging (Jan 2024)
Challenges in Delivering Effective Care for Older Persons with Fragility Fractures
Abstract
Yesid Hurtado,1 Odismar Andrea Hernández,2 Diana Patricia Atencio De Leon,2 Gustavo Duque3,4 1Division of Endocrinology, Hospital San José, Bogotá, Colombia; 2Division of Geriatric Medicine, La cardio/Fundación Cardioinfantil, Bogotá, Colombia; 3Bone, Muscle & Geroscience Research Group, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; 4Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, CanadaCorrespondence: Gustavo Duque, FRACP, FGSA, Research Institute of the MUHC - 1001 Decarie Blvd, Room EM1.3226, Montreal, Quebec, H4A 3J1, Canada, Tel +1514-934-1934 x 35165, Email [email protected]: Fragility fractures occur because of low-impact trauma or even spontaneously in individuals with osteoporosis. Caring for older persons with fragility fractures can present several challenges due to the unique needs and vulnerabilities of this population. Older individuals commonly have multiple medical conditions, such as osteoporosis, arthritis, cardiovascular diseases, and diabetes. These comorbidities can complicate fracture management and increase the risk of complications. Fracture repair through surgery may be more complex in older patients due to poor bone quality, decreased tissue elasticity, and higher chances of anesthesia complications. In addition, mobility and functional limitations post-fracture are highly prevalent in this population, affecting their independence and increasing their risk of institutionalization. Addressing these challenges requires a multidisciplinary approach involving orthopedic surgeons, geriatricians, physical and rehabilitation physicians, physiotherapists, occupational therapists, dieticians, social workers, and caregivers. Preventive measures, such as fall prevention strategies and osteoporosis management, can also play a vital role in reducing the incidence of fragility fractures in older persons.Keywords: osteoporosis, fragility fractures, older persons, osteosarcopenia, rehabilitation