scholarly journals The effect of food supplement with calcium and vitamin D3 on calcium homeostasis and falls incidence in patients with high fracture risk undergoing medical rehabilitation

Bone Reports ◽  
2021 ◽  
Vol 14 ◽  
pp. 100979
Author(s):  
Larisa Marchenkova ◽  
Vasileva Valeria
Keyword(s):  
Fracture Risk ◽  
Calcium Homeostasis ◽  
Vitamin D3 ◽  
Food Supplement ◽  
Medical Rehabilitation ◽  
High Fracture ◽  
Effect Of Food

scholarly journals AB0627 THE EFFECT OF BIOLOGICALLY ACTIVE FOOD SUPPLEMENT WITH CALCIUM AND VITAMIN D3 ADMINISTRATION ON CALCIUM HOMEOSTASIS AND FALLS INCIDENCE IN PATIENTS WITH HIGH FRACTURE RISK UNDERGOING MEDICAL REHABILITATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1347.1-1347
Author(s):  
L. Marchenkova ◽  
V. Vasileva
Keyword(s):  
Vitamin D ◽  
Fracture Risk ◽  
Calcium Homeostasis ◽  
Vitamin D3 ◽  
Calcium Intake ◽  
Food Supplement ◽  
Medical Rehabilitation ◽  
Type I ◽  
High Fracture ◽  
Group 1

Background:Vitamin D and calcium deficiencies is of particular importance in older patients undergoing medical rehabilitation and having a high risk of fractures. Preventing falls and fractures, including during the course of rehabilitation, is an important challenge that can be addressed in these patients, in particular through improved nutrition and vitamin D and calcium supplementation.Objectives:to evaluate the effect of long-term calcium and vitamin D3 intake on calcium homeostasis and fall’s rate in patients with high fracture risk starting rehabilitation course.Methods:The study enrolled 119 men and women aged 50-80 y.o. with high absolute fracture probability by FRAX who started medical rehabilitation. 41 patients have been receiving antiresorptive therapy already comprised group 1, other patients were randomized into groups 2 (n=39) and 3 (control, n=39). In groups 1 and 2, a food supplement containing calcium citrate 1000 mg and vitamin D3 600 IU was prescribed for 12 months. All patients undergo laboratory examination, food calcium intake and fall assessment at baseline, in 6 and 12 months.Results:Daily calcium intake in the study sample (n=119) was 782.9±243.4 mg. Vitamin D deficiency was detected in 38.4% of the examined. An increase in 25(OH)D level was noted in groups 1 and 2 after 6 and 12 months (p<0.01). Patients in group 1 showed an increase in serum osteocalcin and calcium levels after 6 and 12 months (p<0.05). In group 3, there was an increase of immunoreactive parathyroid hormone levels after 6 (p<0.05) and 12 months (p<0.01), C-terminal telopeptide of type I collagen level and alkaline phosphatase activity after 12 months (p<0.05). In group 1, there was also a decrease in proportion of patients who fell after 6 months (χ2=4.97, p=0.026) and a decrease in the total number of falls after 12 months (χ2=4.89, p=0.027). Group 2 showed a decrease in the number of patients who fell after 6 and 12 months (χ2=48.58, p=0.0034 at both stages of the study) and the number of falls in general after 6 months (χ2=6.02, p=0.0142).Conclusion:The obtained data allow us to recommend prescription of dietary supplements containing calcium and vitamin D3 as a part of complex rehabilitation of patients with high fracture risk.Disclosure of Interests:None declared.

scholarly journals Assesment of osteoporotic fractures risk and osteoporosis prevalence among patients over 50 years old undergoing medical rehabilitation

2020 ◽  
Vol 19 (1) ◽  
pp. 13-19
Author(s):  
Larisa A. Marchenkova ◽  
Ekaterina V. Makarova ◽  
Marina Yu. Gerasimenko ◽  
Inna S. Evstigneeva
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Fracture Risk ◽  
Osteoporotic Fractures ◽  
Cross Sectional Study ◽  
Medical Rehabilitation ◽  
Individual Risk ◽  
High Fracture ◽  
Cross Sectional ◽  
Osteoporosis Prevalence

Background. Back pain, limitation of mobility, spinal deformity, decreased ability to self-care due to osteoporotic fractures (vertebrae, femoral neck, humerus, etc.) are one of the reasons for referring patients to rehabilitation and rehabilitation treatment, which involves the use of physical therapy methods, physiotherapy exercises and mechanotherapy. Objective: to assess the prevalence of osteoporosis (OP), individual risk factors for OP, as well as the proportion of people with high risk of osteoporotic low-energy fractures among patients over 50 years old undergoing treatment according to the medical rehabilitation profile. Methods. The study group comprised of 600 patients (426 women and 174 men) aged 50 to 84 years, average age 64.2510.17 years, undergoing treatment in a rehabilitation department. This was a cross-sectional study in the form of unified questionnaire, including data conserning age, weight, height, BMI, clinical and rehabilitation diagnosis, anamnesis of the main disease, anamnesis vitae, presence of OP diagnosis in the anamnesis, its treatment, OP risk factors estimation. An assessment of 10-year probability of osteoporotic fractures was carried out using Russian model of online FRAX calculator. Results. 41.8% patients in the study sample had OP risk factors, including 31.2% ― 3 risk factors or more. 38% patients over 50 years old undergoing medical rehabilitation showed a high fracture risk according to the FRAX calculator. 34.1% had a diagnosis of OP stated, and 45.8% already had osteoporotic fractures. Among those who did not undergo densitometry examination, 69.9% had a history of low-traumatic fractures, and only 58.5% of patients with an established diagnosis of OP and 26.8% of those at high risk of fractures received effective therapy for OP. Conclusion. Among patients over 50 years old undergoing medical rehabilitation a high frequency of OP and high fracture risk were stated. At the same time, insufficient quality of OP diagnostics and anti-osteoporotic therapy administaration were revealed.

scholarly journals Factors associated with initiation of bone-health medication among older adults in primary care in Ireland

2021 ◽  
Author(s):  
Mary E Walsh ◽  
Mari Nerdrum ◽  
Tom Fahey ◽  
Frank Moriarty
Keyword(s):  
Primary Care ◽  
Fracture Risk ◽  
Bone Health ◽  
Retrospective Cohort ◽  
Hormone Replacement ◽  
Inverse Association ◽  
High Fracture ◽  
Factors Associated ◽  
General Practices ◽  
Multimorbid Patients

Abstract Background Adults at high risk of fragility fracture should be offered pharmacological treatment when not contraindicated, however, under-treatment is common. Objective This study aimed to investigate factors associated with bone-health medication initiation in older patients attending primary care. Design This was a retrospective cohort study. Setting The study used data from forty-four general practices in Ireland from 2011–2017. Subjects The study included adults aged ≥ 65 years who were naïve to bone-health medication for 12 months. Methods Overall fracture-risk (based on QFracture) and individual fracture-risk factors were described for patients initiated and not initiated onto medication and compared using generalised linear model regression with the Poisson distribution. Results Of 36,799 patients (51% female, mean age 75.4 (SD = 8.4)) included, 8% (n = 2,992) were observed to initiate bone-health medication during the study. One-fifth of all patients (n = 8,193) had osteoporosis or had high fracture-risk but only 21% of them (n = 1,687) initiated on medication. Female sex, older age, state-funded health cover and osteoporosis were associated with initiation. Independently of osteoporosis and co-variates, high 5-year QFracture risk for hip (IRR = 1.33 (95% CI = 1.17–1.50), P &lt; 0.01) and all fractures (IRR = 1.30 (95% CI = 1.17–1.44), P &lt; 0.01) were associated with medication initiation. Previous fracture, rheumatoid arthritis and corticosteroid use were associated with initiation, while liver, kidney, cardiovascular disease, diabetes and oestrogen-only hormone replacement therapy showed an inverse association. Conclusions Bone-health medication initiation is targeted at patients at higher fracture-risk but much potential under-treatment remains, particularly in those &gt;80 years and with co-morbidities. This may reflect clinical uncertainty in older multimorbid patients, and further research should explore decision-making in preventive bone medication prescribing.

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