ArticleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2022
Osteoporosis Medications Prevent Subsequent Fracture in Frail Older Adults.
Article in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 19 citations in OpenAlex.
- Effectiveness of treatment initiation for secondary fracture prevention in the older population: Japanese Bone-fracture Osteoporosis in Late-stage population Database study (J-BOLD) - emulation of a randomized target trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Trial
- Denosumab for osteoporosis in older adults in long-term care: A randomized trial.Journal of the American Geriatrics Society · 2025Trial
- Osteoporosis medication initiation after proximal humerus fractures is low, but associated with decreased secondary fragility fracture risk.OTA international : the open access journal of orthopaedic trauma · 2026Article
- Effectiveness and Safety of Pharmacological Therapy for Osteoporosis in Frail Elderly Individuals: Systematic Review and Meta-Analysis.Health science reports · 2026Review
- Antiresorptive Use and Risk of Hip Fracture in Older Women with Osteoporosis: Findings from a Real-World National Database of 21,332 Women.Journal of clinical medicine · 2026Article
- Association of frailty trajectories with osteoporosis and hip fracture in an older female population.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Association of frailty with fragility fractures and all‑cause mortality in adults: evidence from the National Health and Nutrition Examination Survey.BMC musculoskeletal disorders · 2026Article
- Shifting bisphosphonate prescribing patterns for fracture prevention: a 24-year national surveillance of men in the U.S. Veterans Health Administration.Archives of osteoporosis · 2026Article
- Underuse of osteoporosis treatments before and after hip fracture: longitudinal findings from the Gruppo Italiano di Ortogeriatria (GIOG 2.0) study.Frontiers in aging · 2026Article
- Association between creatinine clearance and lumbar bone mineral density in Chinese patients with osteoporotic fractures: a retrospective cross-sectional study.Frontiers in endocrinology · 2026Article
- Exploring the dilemma of secondary fracture prevention in Chinese families from the experience of elderly fragility fractures: a qualitative study based on Confucian cultural background.BMC geriatrics · 2025Article
- Development and validation of a predictive model for refracture risk in elderly individuals with osteoporotic vertebral compression fracture: a retrospective study in China.Aging clinical and experimental research · 2025Article
- Impact of Frailty and Other Factors as Estimated by HU to Predict Response to Anabolic Bone Medications.Journal of clinical medicine · 2025Article
- Association between creatinine clearance and mortality in Chinese patients with osteoporotic fractures: a retrospective cohort study.Frontiers in medicine · 2025Article
- Regional Variation in Deescalated Therapy in Older Adults With Early-Stage Breast Cancer.JAMA network open · 2024Article
- Claims-Based Frailty Index and Its Relationship With Commonly Used Clinical Frailty Measures.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Enabling osteoporosis treatment in post-acute care: An algorithm for providers.Geriatric nursing (New York, N.Y.)Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
Frailty is common in older adults with fractures. Osteoporosis medications reduce subsequent fracture, but limited data exist on medication efficacy in frail individuals. Our objective was to determine whether medications reduce the risk of subsequent fracture in frail, older adults. A retrospective cohort of Medicare fee-for-service beneficiaries was conducted (2014-2016). We included adults aged ≥65 years who were hospitalized with fractures without osteoporosis treatment. Pre-fracture frailty was defined using claims-based frailty index (≥0.2 = frail). Exposure to any osteoporosis treatment (oral or intravenous bisphosphonates, denosumab, and teriparatide) was ascertained using Part B and D claims and categorized according to the cumulative duration of exposure: none, 1-90 days, and >90 days. Subsequent fractures were ascertained from Part A or B claims. Cause-specific hazard models with time-varying exposure were fit to examine the association between treatment and fracture outcomes, controlling for relevant covariates. Among 29,904 patients hospitalized with fractures, 15,345 (51.3%) were frail, and 2148 (7.2%) received osteoporosis treatment (median treatment duration 183.0 days). Patients who received treatment were younger (80.2 versus 82.2 years), female (86.5% versus 73.0%), and less frail (0.20 versus 0.22) than patients without treatment. During follow-up, 5079 (17.0%) patients experienced a subsequent fracture. Treatment with osteoporosis medications for >90 days compared with no treatment reduced the risk of fracture (hazard ratio [HR] = 0.82; 95% confidence interval [CI] 0.68-1.00) overall. Results were similar in frail (HR = 0.85; 95% CI 0.65-1.12) and non-frail (HR = 0.80; 95% CI 0.61-1.04) patients but not significant. In conclusion, osteoporosis treatment >90 days was associated with similar trends in reduced risk of subsequent fracture in frail and non-frail persons. Treatment rates were very low, particularly among the frail. When weighing treatment options in frail older adults with hospitalized fractures, clinicians should be aware that drug therapy does not appear to lose its efficacy. © 2022 American Society for Bone and Mineral Research (ASBMR).
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