(精选)Supplements in falls patients教学课件.pptVIP

Choice of bone protecting agent NICE committee recommendations Elderly population can’t be assumed to have an adequate dietary intake of calcium vit D Normal serum concentrations of calcium vitamin D are needed to ensure optimum effects of the treatments for osteoporosis Thus calcium + vitamin D prescribed unless clinicians are confident that levels are normal Evidence for Calcium Vit D supplementation Reviewed in the 2001 RCP Osteoporosis Guidelines Guidelines unclear if the benefits of Tx due to vitamin D calcium combination of both Calcium 1g/day ↓ bone loss in women with osteoporosis (level Ia) ↓ the risk of vertebral fracture (leveI Ib) effects on hip fracture are less certain (Level II) Vitamin D 800 iu/day ↓ hip other # in the institutionalised frail elderly (level Ib) beneficial effects in the general community have not been demonstrated. Vitamin D calcium in elderly female patients saves great resources low marginal costs is recommended that these individuals be offered such treatment (grade A) Supplements in falls patients Dr Nick John Deepak Jadon (SHO) Older People’s Unit October 2007 Overview Background Objective Standards Methods Results Conclusion Recommendations Discussion Background - Osteoporosis Progressive skeletal disease characterised by low bone mass micro-architectural deterioration Resulting in ↑ bone fragility ↑ susceptibility to fracture 2 types of osteoporosis Involutional / senile ↓ cortical trabecular bone Post-menopausal steroid-induced ↓ trabecular bone mainly Standards  RCP working party report 2001 suggests consideration of Calcium + Vit D supplementation in patients with Incident / prevalent falls Housebound with limited sun exposure Poor mobility Potential for malnutrition Frail VERY MUCH THE COHORT ON OPU ! Working Party Reports 2001. Osteoporosis. Clinical guidelines for prevention and treatmentUpdate on pharmacological interventions and an algorithm for managementRoyal College of Phys