Bone Mineral Density in Residents of Care Facilities for the Aged and Effect of Pharmacotherapy

BACKGROUND Bone mineral densitometry has been proven to be a powerful tool for the diagnosis and treatment of osteoporosis, which is increasing with aging of the population, but opportunities to perform bone mineral densitometry in elderly facility residents, who are at a high risk of fracture, are scarce. METHODS We measured the bone mineral density in 315 residents of 5 care facilities for the aged in middle Tottori Prefecture from 2002 to 2006. We also evaluated residents of an elderly nursing home with a history of fragility fracture and those with osteoporosis who were administered risedronate for its therapeutic effect. RESULTS The bone mineral density was less than 70% of the young adult mean in 161 (51.1%) of the 315 subjects (aged 83.1 ± 7.8 years), 149 (57.8%) of the 258 women (83.9 ± 7.2 years), and 12 (21.1%) of the 57 men (79.8 ± 9.3 years). In the 13 subjects who were administered risedronate, the bone mineral density increased from 65.8 to 67.2% of the young adult mean from before to after the beginning of administration, but it decreased in the control group (n = 9). In those administered risedronate, the urinary level of N-telopeptide (a marker for bone resorption) began to decrease 3 months after the beginning of the administration and showed a significant decrease after 11 months (n = 8) compared with the control group. The mean pain score based on the visual analogue scale showed significant reduction in the risedronate group compared with the control group. CONCLUSION The bone mineral density was low in the facility residents and was less than 70% of the young adult mean in 57.8% of women and in 21.1% of men, more frequently than expected. Bone resorption and osteoporotic pain were suppressed by risedronate in osteopenic patients in such care facility.