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Screening for osteoporosis
 — a survey of older psychiatric inpatients at a tertiary referral centre
Author(s)Brendon Stubbs, Enrique Zapata-Bravo, Camilla Haw
Journal titleInternational Psychogeriatrics, vol 21, no 1, February 2009
Pagespp 180-186
Sourcehttp://www.journals.cambridge.org/ipg
KeywordsOsteoporosis ; Screening ; Psychogeriatric patients ; Clinical surveys.
AnnotationOsteoporosis causes much morbidity and mortality among elderly people. Older inpatients with severe mental illness may be at particular risk of osteoporosis because of factors including immobility, vitamin D deficiency and psychotropic medication. Predominantly older inpatients with severe mental illness were screened for osteoporosis using a peripheral DEXA scanner. Associations were examined between patient variables and osteoporosis as detected by DEXA scan, Z-scores and history of fragility fractures. Patients were followed up to see how many subsequently received drug treatment for osteoporosis. Patient acceptability of the scanning technique was also assessed. It was possible to scan 72/89 (81%) of patients. 42 (58%) patients had osteoporosis and 23 (32%) osteopenia. 12 (17%) patients with a history of fragility fractures had osteoporosis on DEXA scan. A scan suggestive of osteoporosis and a history of fragility fractures were both associated with age of 75 years and over and thoracic kyphosis. Low Z-scores were associated with longer hospital stay and osteoporosis predisposing drugs. Patient acceptability of scanning was high. At follow-up, only 7/16 (44%) patients were suitable for central scanning and 9/40 (23%) for bisphosphonates. Older institutional patients with severe mental illness are likely to be at high risk of developing osteoporosis. Peripheral DEXA scanning is acceptable to these patients and identifies those at high risk of fractures. However, some behaviourally-disturbed patients are not suitable for central scans or for some osteoporosis drug treatments. (KJ/RH).
Accession NumberCPA-090825229 A
ClassmarkCLO: 3V: LF:E: 3G

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