Preventing fractures in elderly people

doi:10.1136/bmj.327.7406.89

BMJ 2003;327:89-95 (12 July), doi:10.1136/bmj.327.7406.89

Clinical review

Preventing fractures in elderly people

Anthony D Woolf, professor of rheumatology¹, Kristina Åkesson, associate professor²

¹ Institute of Health and Social Care, Peninsula Medical School, Royal Cornwall Hospital, Truro TR1 3LJ, ² Lund University, Department of Orthopaedics, Malmö University Hospital, S-20502, Malmö, Sweden

Correspondence to: A D Woolf anthony.woolf@rcht.swest.nhs.uk

Preventing fractures in elderly people is a priority, especiallyas it has been predicted that in 20 years almost a quarterof people in Europe will be aged over 65. This article describesthe factors contributing to fracture, interventions to preventfracture, and the various treatments.

The first 150 words of the full text of this article appear below.

Introduction

Fractures in elderly people are an important public health issue, especially as incidence increases with age, and the populationof elderly people is growing. Evidence based interventionsdo exist to prevent fractures, but they are not being applied.^1
2 The challenges are to identify those most risk and to ensurethat treatment is cost effective. Elderly people should betaught to improve their bone health and to reduce the riskof injury, but these measures are not restricted to this agegroup, as prevention should be throughout the life.³

Sources and methods

Recommendations are made following a comprehensive review ofthe literature, concentrating on systematic reviews and evidencebased guidelines on fracture prevention that have been identifiedby a standardised search strategy as part of the European Boneand Joint Health Strategies Project. Priority was given tothose systematic reviews and guidelines that met quality criteria,including criteria for guidelines from the Appraisal of . . . [Full text of this article]

A universal problem

Bone fragility, falls, and people at high risk

Pharmacological interventions

Impact and prevention of falls

Lifestyle

Selective case finding

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Selection of treatment and monitoring response

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