MDNews - Long Island

February 2021

Issue link: https://viewer.e-digitaledition.com/i/1347209

Contents of this Issue

Navigation

Page 19 of 31

Healthier Lifestyles BY THOMAS CROCKER A NE W STUDY FINDS THAT DECRE A SES IN T WO OSTEOPOROSIS RISK FACTORS — SMOKING AND HE AV Y ALCOHOL USE — HELP ACCOUNT FOR A STE ADY DROP IN HIP FR ACTURE R ATES IN THE U.S. OVER 40 YE ARS. M A N Y RE SE A RCHER S THEORIZED that the introduction of drugs to bolster bones and prevent fractures, such as bisphosphonates, in recent decades was responsible for fewer hip fractures, but that does not tell the whole story, according to Douglas Kiel, MD, MPH, Director of the Musculoskeletal Research Center and Senior Scientist at the Hinda and Arthur Marcus Institute for Aging Research, and Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center. "The decline in hip fractures started before many medications were FDA-approved," Dr. Kiel says. "In addition, the healthcare system does a terrible job of treating people to prevent fractures, and our use of available drugs is abysmal." Using data from the long-running Framingham Heart Study, Dr. Kiel and colleagues at Harvard Medical School and the NIH found another factor at play — changing lifestyles. BACK TO BASICS The researchers analyzed data from 10,552 individuals from 1970 to 2010 and found that age-adjusted hip fracture rates fell 4.4% each year. That coincided with a decrease in the smoking rate from 38% to 15% and a decline in heavy drinking from 7% to 4.5%. Other hip fracture risk factors were static. The study appeared in JAMA Internal Medicine. The association between fewer hip fractures and less smoking and heavy drinking makes sense, given what researchers and clinicians know about their detrimental effects on bone health. Dr. Kiel hopes the study's findings prompt clinicians to focus on primary prevention of osteoporosis. "In clinic visits, physicians would probably be more effective at prevent- ing terrible outcomes by spending extra time on smoking cessation, fall prevention or getting individuals into alcohol treatment than on a typical physical exam," Dr. Kiel says. "Building time for primary osteoporosis prevention into the general health care of middle-aged and older adults is valuable." n Arrested Momentum A DECA DE S-LONG DECLINE in hip fractures in the U.S. has stalled. Focusing on prevention in the most vulner- able patients could be a solution, according to an author of a recent study on the topic. "We have a problem because our popula- tion is older and the decline in hip fractures is not happening any- more," says Douglas Kiel, MD, MPH, Director of the Musculoskeletal Research Center and Senior Scientist at the Hinda and Arthur Marcus Institute for Aging Research, and Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center. "While smoking and drinking are certainly worth paying attention to, poor prescribing practices for preventing fractures are not to be discounted. Treating patients who've had a fracture is the low-hanging fruit. They are the most fragile, vulnerable individuals." Dr. Kiel says primary care physicians could have a significant impact by prioritizing preven- tion of subsequent hip fractures. That includes encouraging lifestyle modifications and prescribing medica- tions that are proven to strengthen bones. May Help Explain Long-Term Hip Fracture Decline SPECIAL CLINICAL SECTION: ORTHOPEDICS 2 0

Articles in this issue

Archives of this issue

view archives of MDNews - Long Island - February 2021