Fracture Risk Assessment in a Tertiary Centre Memory Clinic
Aims: The aim of the study was to identify the proportion of patients presenting to the memory clinic at a high risk of fracture based on the FRAX and Garvan fracture risk calculators. Of those identified as being at high risk, we aimed to identify whether this issue was addressed either at baseline review or at their previous review. Methodology: One hundred consecutive patients attending clinic in 2012 were audited over a 6 month period. A mixed method methodology was utilised for data collection. Subsequently the FRAX and Garvan score was calculated for all 71 patients. Fracture risk calculator scores were categorised into low and high risk according to the classification system followed by the Gairdner densitometry department at SCGH. Results: The study sample had a mean age of 81.20 with a range from 64 to 91 years of age. The average MMSE score was 23.75 with a range from 10 to 30 points. It was found that 64.8% of the participants received no form of first line bone health specific therapy. Despite the study sample having a mean FRAX and Garvan scoring that indicated high risk for fractures (except with FRAX major) just 35.2% of patients were on any form of first line therapy and only 9.9% were on specific ART. Conclusion: A significant proportion of people attending the tertiary centre memory clinic were identified as being at high fracture risk. The overriding observation of the lack of bone specific treatment in individuals at high fracture risk becomes important given the increased vulnerability of the population being studied here. This could have a significant impact not only on reduction in osteoporotic fracture disease burden but also on the associated health costs therein.
Fracture Risk, Dementia, Osteoporosis, FRAX Score, Garvan Score
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