Elderly/Long-term Care

Few nursing home residents receive medications and supplements for osteoporosis

An estimated 70 to 85 percent of nursing home residents have osteoporosis, a loss of bone density. This disease can lead to debilitating fractures among the frail elderly in nursing homes, where falls are commonplace. Yet, less than 1 in 10 newly admitted nursing home residents receive osteoporosis-fighting medications and/or calcium and vitamin D supplements, according to a new study.

Using a database to identify newly admitted residents to nursing homes in five States between 1998 and 2000, the researcher examined use of medications (alendronate, risedronate, calcitonin, estrogen, and raloxifene) or supplements (calcium with vitamin D) that are used to treat osteoporosis. Nine percent of the nursing home residents studied received medications and/or supplements for osteoporosis. The most commonly used treatment was the combination of calcium and vitamin D (5 percent). Use of calcitonin (2.5 percent), a hormone secreted by the thyroid gland that controls levels of calcium and phosphorus in the blood, exceeded that of any other bone-sparing medications.

Individuals diagnosed with osteoporosis were over six times more likely and women were nearly three times more likely to receive an osteoporosis treatment than other new nursing home residents. The number of other medications residents took was also strongly associated with receiving osteoporosis treatment. Black residents were 37 percent less likely, and those diagnosed with four to six other conditions were 29 percent less likely to receive osteoporosis treatment.

The author of the study cautions that these findings were based on medication use from 1998 to the end of 2000, and new guidelines and medications to treat osteoporosis have appeared since then.

The study was supported in part by the Agency for Healthcare Research and Quality (T32 HS00011).

More details are in "Use of osteoporosis medications in older nursing facility residents," by Rollin M. Wright, M.D., M.A., in the September 2007 Journal of the American Medical Directors Association 8, pp. 453-457.

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