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JAMA Insights
Clinical Update
May 10, 2019

Hip Fractures in Older Adults in 2019

Author Affiliations
  • 1Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts
  • 2Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • 3Duke University School of Medicine, Durham, North Carolina
JAMA. 2019;321(22):2231-2232. doi:10.1001/jama.2019.5453

The incidence of osteoporotic fracture increases exponentially throughout life, as does the risk of the devastating consequences of these fractures, including functional decline, institutionalization, mortality, and destitution.1 Adults in their eighth and ninth decades of life are less likely to be screened and treated for osteoporosis than younger individuals. Guidelines for pharmacologic treatment suggest using 10-year fracture risk estimations, but they do not address decision making for patients with life expectancies less than 10 years. Further, existing fracture risk calculators do not include many comorbidities or frailty characteristics common in older adults that influence risk-benefit assessment when considering pharmacologic treatment as a preventive measure for osteoporosis.

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