This is how the pandemic affects the treatment of osteoporosis

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Fall in controls and greater difficulties in recovering from hip fractures are two of the indirect consequences, according to local studies.

It is estimated that one in three women and one in five men break after age 50 due to osteoporosis. The most feared is a hip fracture, because it can result in loss of independence or death (up to one in four die in the following year). The isolation measures to contain the spread of the coronavirus added difficulties to those who recover after surgery and contracted the number of consultations and studies, according to two studies carried out in the City.

Frailty, difficulties in recovery and greater clinical instability as a consequence of pre-existing chronic diseases. These were the main results of “Prolonged social isolation during the COVID-19 pandemic and the epidemiology of hip fracture”, an investigation carried out by a team from the Italian Hospital of the City of Buenos Aires that analyzed a group of hospitalized patients for fractures caused by osteoporosis between April and July of this year.

“We began to perceive that the patient who suffered a hip fracture came to hospital in other conditions, with more comorbidities. Since our hospital work is always multidisciplinary, we were able to collect the experience of different sectors. And so it was that we observed greater fragility, even the kinesiology team pointed out that during the immediate postoperative period, the patients were not moving, they could not stop or it was much more difficult for them to do the activities they usually do. All of this is the result of greater fragility “, explains Bruno Boietti, a clinician and geriatrician, a member of the medical clinic service.

“Also, given the context, there were changes in hospital care: the family member could no longer accompany the patient hospitalized, he could not assist him to eat and the number of admissions to the rooms for the daily controls was reduced “, he described and alluded to a multifactorial problem.” The lifestyle of the elderly changed: they stopped exercising, they do not expose themselves to the sun, they changed their eating habits, they receive fewer visitors, they are distressed because they do not see their grandchildren. The final product is more fragile, “he summarized.

On the other hand, a survey carried out by the IDIM indicated that the number of consultations for osteoporosis fell by 49% and the number of densitometries decreased by 81%, compared to the same period in 2019.

“These results are a sample of the impact of this situation on the health of patients with chronic diseases”, reflected María Belén Zanchetta, endocrinologist, specialist in osteology and medical and academic director of IDIM.

“In this context, patients do not sunbathe and, therefore, we see more and more vitamin D deficiency, they do not exercise. Patients note that they lost muscle mass. Skeletal muscle mass decreases by almost 50% between the ages of 20 and 90. And one of the consequences of this prolonged sedentary lifestyle will be the loss of muscle mass in older adults. Which is crucial for the bone, for the metabolism of carbohydrates. Muscle mass is a treasure for the elderly and it will be very difficult to recover, “he said.

“A study we recently published shows that, before the isolation period, 12.5% ​​of the women we evaluated over 60 had sarcopenia, that is, low muscle strength and muscle mass. These women had a significantly higher frequency of falls, osteoporosis and vertebral fractures. The risk of fragility fractures was increased 6 times. That is why its diagnosis could be considered a useful tool to identify those adults at increased risk of falls and fractures, “he explained.

Most hip fractures occur after a fall at home. In this sense, the IDIM recommends adopting a series of measures to condition the home and make it a safe environment, given that osteoporosis is the main cause of fractures in postmenopausal women and older adults in general.

✔ At night, leave a dim light on in bathrooms and bedrooms.

✔Fix the edges of the rugs.

✔Eliminate excess wires or cables in curtains, telephones or lamps.

✔Avoid the placement of doormats and floor rags.

✔ Do not walk on wet or waxed floors.

✔Sit on the bed before getting up and slowly getting up.

✔ Do not walk in slippers, flip flops or socks.

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