Bone Abstracts

Osteoporosis and fragility fractures correlated, are a major clinical problem in older women and men and a major public health problem worldwide. As the population ages, the incidence of osteoporotic fractures is increasing. These fractures are associated with higher health care costs, physical disability, impaired quality of life, and increased mortality.

Aim: evaluation of the frequency, type and age of onset of fragility fractures in 110 centenarians (≥ 98 years) living at Nursing Home Pio Albergo Trivulzio of Milan. We studied retrospectively (from 1995 to 2012) demographic and physio-pathologic characteristics in 110 subjects (5 males, 105 females; 98–109 years).

Results: 92 patients had fractures, while 18 of them never had any fragility fractures. Thirty-one had a single fracture (26 femurs, 2 humerus, 1 pelvis, and 1 knee, 1 vertebra), while 61 multiple. The most frequent fracture sites were the following: femur in 57 cases (52%), both femurs in 7 cases (8%), vertebras in 34 cases (31%), pelvis in 10 cases (12%), humerus in 13 cases (12%), tibia 6 (5%), humerus and femur in 5 cases (4%), ribs 5, knees 4 (4%), wrists 3 (4%), foot 3, clavicle 3, elbow, fingers, radius, 2 (2%) each, other (shoulder, malleolus) 1 (1%) each. 94% cases multiple vertebral fractures were observed. Within the group of patients who had severe osteoporosis with multiple fragility fractures it is to mention the case of a female patient, with a pelvic fracture at 91 years, a right shoulder fracture at 92, a fracture of the left femur at 93 and one of the left elbow at 99 years of age. Another female patient had a left femur fracture at 89 years, a left humerus fracture at 90 and a fracture of the right femur at 91, followed by a vertebral fracture of D12.

Conclusions: Our data show high prevalence of osteoporosis associated with fragility fractures (84%) and of severe osteoporosis associated with multiple fragility fractures (56%). Age is a risk factor of great importance for osteoporosis fractures and it is independent from mineral bone density. The results of our study show the importance of primary and secondary prevention, independently from age. In the ageing population contest, prevention and treatment of osteoporosis is a major public health concern.