Screening and Treatment for Osteoporosis After Stroke
Eshita Kapoor1, Peter C Austin2, Shabbir M H Alibhai1
1From the Department of Medicine, University of Toronto, Canada (E.K., S.M.H.A., A.M.C., P.C., L.K.C., M.P., M.K.K.).
Stroke
|April 26, 2019
Summary
Stroke survivors are rarely screened or treated for osteoporosis, increasing their fracture risk. This study highlights the need for better bone health management in post-stroke patients.
Area of Science:
- Gerontology
- Neurology
- Endocrinology
Background:
- Stroke is a significant risk factor for developing osteoporosis and subsequent fractures.
- Bone loss and fracture risk are often overlooked in post-stroke care pathways.
Purpose of the Study:
- To determine current screening and treatment rates for bone loss in patients following a stroke.
- To identify predictors associated with bone mineral density testing and osteoporosis pharmacotherapy after stroke.
Main Methods:
- Analysis of the Ontario Stroke Registry (2003-2013) for patients aged 65+ experiencing a stroke.
- Calculation of cumulative incidence for bone mineral density (BMD) testing and fracture prevention medication within one year post-stroke.
- Utilized cause-specific hazard models to assess covariate effects on screening and treatment.
Main Results:
- Only 5.1% of patients underwent BMD screening, and 15.5% received fracture prevention medication within one year post-stroke.
- Screening rates were particularly low (2.9%) among those not previously tested; treatment initiation was low (3.2%) for those not on prior medication.
- Female sex, pre-existing osteoporosis, and post-stroke falls/fractures were linked to higher rates of osteoporosis pharmacotherapy.
Conclusions:
- Patients with recent strokes are inadequately screened and treated for osteoporosis, leading to a potential increase in fracture risk.
- There is a critical need to identify and implement effective osteoporosis management strategies for high-risk individuals post-stroke.
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