Elderly patients scheduling an appointment with the orthopedic surgeon may want to schedule with their ophthalmologist as well.
Cataracts Linked to Osteoporosis, Fracture?
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#osteoporosisSecondary#fractures#cataracts
New research has found evidence of an association between cataracts and increased risks of osteoporosis and fractures. The work, “Association Between Cataract and Risks of Osteoporosis and Fracture: A Nationwide Cohort Study,” appears in the October 3, 2018 edition of the Journal of the American Geriatrics Society.
Shu-Man Lin, M.D., with the Department of Physical Medicine and Rehabilitation at the Buddhist Tzu Chi General Hospital in Hualien, Taiwan, and co-author on the study explained his findings to OTW, “Osteoporosis and fractures cause significant morbidity, mortality, and considerable socioeconomic burden in the aging population. My colleagues and I have devoted ourselves to investigate the possible risk factors for osteoporosis and fractures, and to find ways to prevent such medical problems.”
“Cataracts have a very high prevalence and are the leading cause of visual impairment in the elderly. We aimed to evaluate the association between cataracts and the occurrence of osteoporosis and fractures, and to investigate the possible effect of cataract surgery on osteoporosis and fracture risks.”
The authors found that “During mean follow‐up of 6.4 years, 17,450 participants with cataracts and 12,627 without cataracts developed osteoporosis or fractures.”
Dr. Lin told OTW, “This nationwide population-based cohort study demonstrated a significant association between cataract and increased risks of osteoporosis and fractures. Further, among cataract patients, a potentially beneficial effect of cataract surgery was observed in reducing the risk of osteoporosis and fractures.”
“We believe that appropriate management for cataracts may decrease the risks of osteoporosis and fractures. In addition, we recommend that all elderly persons who have osteoporosis or fractures, or those at a high risk for developing these diseases, should have their vision checked.”
“We recommend that the assessment of patients with osteoporosis or fractures should routinely include screening for cataract and vision checks.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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