Falls and osteoporotic fractures in elderly people

Question 1

Clinical risk factors for hip fracture

Answer 1

• Low bone mineral density
• Age
• Female gender
• Low body weight
• Family history of hip fracture
• Prior history of hip fracture
• Smoking
• Ethnicity
• Corticosteroid use
• Medications e.g. psychotropic drugs

Question 2

Risk factors for falling

Answer 2

• Muscle weakness
• History of falls
• Gait deficit
• Balance deficit
• Visual deficit
• Arthritis
• Impaired ADL
• Cognitive impairment
• Age >80yrs

Question 3

Medical conditions that increase risk of falling

Answer 3

• Parkinson’s disease
• Stroke
• Hypotension
• Depression
• Epilepsy
• Dementia
• Arthritis
• Dizziness and vertigo
• Peripheral neuropathy

Question 4

Ways of preventing hip fractures

Answer 4

1. Fall prevention
2. Bone protection
   - Systemic: medication
   Biophosphonates
   Vit D and calcium
   HRT
   Teriparatide (PTH)
   Denosumab - reduces osteoclast activity

• Local: hip protectors