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Tuesday, December 11, 2012
Doctors use broken bones to help unmask dementia in elderly patients who may otherwise not be diagnosed
From the Daily Mail:
Doctors are using broken wrists to diagnose dementia in elderly patients.
They say brain impairment caused by conditions like Alzheimer's make falling over more likely, yet many older people with broken bones remain undiagnosed.
They often get advice on how to strengthen their bones, but little effort is made to identify problems with dementia, it is claimed.
In a pilot project at Southampton General Hospital, patients over 70 who fracture bones in a fall but do not need to stay in hospital admission are sent from the emergency department to be seen by a team of orthopaedic, osteoporosis and elderly care specialists.
As well as treatment for broken wrists, arms and shoulders, patients are given a basic physical and mental assessment to find out why they are falling to minimise their future risk and prevent more serious fractures of the hips or spine.
There are currently 75,000 cases of hip fracture in the UK every year among people of an average age of 80 years, but experts believe this could be cut by earlier intervention looking at a whole range of health problems.
Dr Mark Baxter, a consultant in elderly care and bone health who is co-leading the initiative at Southampton, said 'About 40 per cent of people who have a hip fracture have got dementia or some form of cognitive dysfunction and, of them, a significant proportion are not diagnosed, probably more than 25 per cent.
'We also know around half of all hip fracture patients have fractured bones before, and between 25 and 30 per cent of all people who break their hip die within a year, so it is clear these patients are extremely vulnerable and, based on current statistics, in need of much wider intervention than they currently receive.'
Following a full assessment by a consultant geriatrician, those who show signs of being at high risk of falling over again are referred directly to the falls service and, if required, to a specialist dementia clinic.
Simon Tilley, a consultant orthopaedic surgeon and joint project lead, said 'We are going to treat these patients' wrist or shoulder fractures, but the knock-on effect will be that we hope to prevent the more serious and life-threatening fractures later on.
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