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Usefulness of bone density measurement in fallers.

Hubert Blain 1 Yves Rolland Olivier Beauchet 2 Cedric Annweiler 3 Claude-Laurent Benhamou Athanase Benetos 4 Gilles Berrut 5 Maurice Audran 6 Sauveur Bendavid 7 Valérie Bousson 8 Karine Briot 9 Michel Brazier 10 Véronique Breuil 11 Laure Chapuis 12 Roland Chapurlat 13 Martine Cohen-Solal 14 Bernard Cortet 15 Patricia Dargent 16 Patrice Fardellone 17 Jean-Marc Feron 18 Jean-Bernard Gauvain 19 Pascal Guggenbuhl 20, 21 Olivier Hanon 22 Michel Laroche 23 Sami Kolta 24 Eric Lespessailles 25 Brigitte Letombe 26 Eric Mallet 27 Christian Marcelli 28 Philippe Orcel 29 François Puisieux 30 Patrick Seret 31 Jean-Claude Souberbielle 32 Bruno Sutter 33 Florence Trémollières 34 Georges Weryha 35 Christian Roux 1 Thierry Thomas 35
Abstract : The objective of this systematic literature review is to discuss the latest French recommendation issued in 2012 that a fall within the past year should lead to bone mineral density (BMD) measurement using dual-energy X-ray absorptiometry (DXA). This recommendation rests on four facts. First, osteoporosis and fall risk are the two leading risk factors for nonvertebral fractures in postmenopausal women. Second, BMD measurement using DXA supplies significant information on the fracture risk independently from the fall risk. Thus, when a fall occurs, the fracture risk increases as BMD decreases. Third, osteoporosis drugs have been proven effective in preventing fractures only in populations with osteoporosis defined based on BMD criteria. Finally, the prevalence of osteoporosis is high in patients who fall and increases in the presence of markers for frailty (e.g., recurrent falls, sarcopenia [low muscle mass and strength], limited mobility, and weight loss), which are risk factors for both osteoporosis and falls. Nevertheless, life expectancy should be taken into account when assessing the appropriateness of DXA in fallers, as osteoporosis treatments require at least 12months to decrease the fracture risk. Another relevant factor is the availability of DXA, which may be limited due to geographic factors, patient dependency, or severe cognitive impairments, for instance. Studies are needed to better determine how the fall risk and frailty should be incorporated into the fracture risk evaluation based on BMD and the FRAX® tool.
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01128189
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Submitted on : Monday, March 9, 2015 - 1:51:20 PM
Last modification on : Monday, November 30, 2020 - 1:44:51 PM

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Hubert Blain, Yves Rolland, Olivier Beauchet, Cedric Annweiler, Claude-Laurent Benhamou, et al.. Usefulness of bone density measurement in fallers.. Joint Bone Spine, Elsevier Masson, 2014, 81 (5), pp.403-8. ⟨10.1016/j.jbspin.2014.01.020⟩. ⟨hal-01128189⟩

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