老年骨质疏松性骨折的预防和干预.ppt

* * * * Pain and deformity from VCF Decreased mobility, decreased tolerance of activities of daily living Less activity=more bone loss Compressed abdomen=decreased appetite Sleep disorders could be caused by discomfort, breathing difficulties * Decreased Quality of Life Physical Patient fears additional fracture w/activity Less active (which exacerbates bone loss further) Psychological Increased depression Reduced self worth Increased anxiety Isolation(less active) Increased dependence on others * * * * * * * * According to the World Health Organization, bone mineral density is an important tool to classify patients as osteoporotic. Bone density is reported as BMD (Bone Mineral Density). The T-score compares the patient’s BMD to the young adult reference population. A T-score of -2.5 or lower is an indication of osteoporosis. * * Fracture risk increases continuously as the T-score values decrease. The World Health Organization considers a T-score above -1T to be normal. T-scores between -1 and -2.5 indicate osteopenia. A T-score below -2.5 indicates osteoporosis. For example, the 60-year-old female patient plotted on the graph has a T-score value below the Young Adult mean but near the Age-Matched mean.. This indicates the patient has an increased risk of fracture, but one that is typical for patients of her age. There is no clear demarcation for increased risk of fracture at a specific given level of BMD, but rather there is a continuous gradient of risk. BMD values should be considered together with other risk factors (low body weight, fracture history, corticosteroid use, use of long-acting tranquilizers, history of falling) in patient evaluation. In particular, patients with a prior history of osteoporotic fracture should be considered to have double the risk of future fracture at any density level. * * Recommendations for Care of the Osteoporotic Fracture Patient to Reduce the Risk of Future Fracture Developed by the World Orthopedic Osteoporosis Organ