A dramatic surge in fractures and their complications in the over 65s is expected in the coming months, according to the study UCBM
July 17, 2020 - The elderly are the most affected not only by Covid-19 but also by numerous other related pathologies, such as osteoporosis. The statistics speak for themselves: already today, 80 percent of people treated for a fracture do not receive anti-osteoporosis therapy, thus increasing the risk of related pathologies and new fractures. The stop in recent months of health activities on chronic diseases, such as osteoporosis and rehabilitation, makes experts predict a new surge in fractures. Prof. says this in an article published in the prestigious scientific journal Nature Reviews Endocrinology. Nicola Napoli, doctor of the Endocrinology Unit of the Campus Bio-Medico University Hospital who raises the alarm: “In Italy, just 20 percent of patients with fractures undergo anti-osteoporosis therapy, while the remaining 80 percent receive no treatment. It is as if a patient, after a heart attack, was discharged without being prescribed treatment based, for example, on statins or beta-blockers. We want to make doctors and patients aware of a silent emergency that risks exploding in all its drama after the Covid-19 epidemic".
The ongoing pandemic around the world and the care of patients with bone fragility are therefore closely connected. The available data indicate that the majority of hospitalized patients with Covid-19 are over 60 on average, they are fragile subjects e with at least one other disease in progress which, together with immobilisation and long-term treatments, increase the risk of bone fragility and fractures. According to the latest data available in Italy there are about 3,5 million women and 1 million men affected by osteoporosis. Over the next 20 years, with the progressive aging of the population, a 25 percent increase in the over 65s is expected, and the Italian Osteoporosis Society estimates a proportional increase in the incidence of osteoporosis in the population.
Unfortunately in the Covid-19 emergency, in many countries of the world, osteoporosis patients have been classified as "non-urgent" since this pathology does not affect vital parameters. But for this very reason, experts predict one in the coming months dramatic upsurge in fractures and related mortality. "In patients aged 65 and over, immobilization rapidly leads to loss of muscle mass and strength – continues the prof. Nicholas Naples - This, together with other Covid-19-related pathologies, such as chronic inflammation and frailty, contributes to an increased likelihood of falls and related fractures".
The risk of death for patients with a hip fracture is 15 to 30% within a year: the incidence of osteoporotic fractures on mortality is substantially comparable to that of stroke and breast cancer. Furthermore, two thirds of those who survive often find themselves in a condition of permanent disability and dependence on family members and caregivers, not to mention the direct and indirect costs borne by the community.
For this the prof. Nicholas Naples appeal"At this point in the pandemic, more attention needs to be paid to those suffering from osteoporosis. The management of these patients is already complex under normal circumstances. With the pandemic still ongoing and considering the current difficulties in visiting patients in hospital settings, an effort is needed to guarantee them adequate treatments: in fact, continuity of care is not only a prerequisite for the success of the treatment itself, but it is important to ensure patient survival over time".
