Dysmobility syndrome: a paradigm shift in fracture prevention
Fragility fractures engender major healthcare cost, reduce independence/quality and life and increase mortality risk. Despite availability of multiple therapies to reduce risk for future fracture, few patients are treated even following hip fracture. Clearly, approaches of the past aimed at reducing fragility fracture risk, primarily by diagnosing osteoporosis and initiating bone-active medications, have failed. A different approach is required; such a change in focus is proposed here. Briefly, the dysmobility syndrome concept recognizes fragility fracture as the clinical outcome of consequence and appreciates that osteoporosis is only part of the syndrome leading to “osteoporosis-related” fracture. Other components of this syndrome include sarcopenia, obesity, diabetes, osteoarthritis, and potentially multiple other factors that increase risk for falls with attendant increased fracture risk. In summary, the dysmobility syndrome concept moves the field, and also, importantly, older adults at risk for fragility fracture, beyond a singular focus on bone to more appropriately focus on a holistic approach to fracture risk reduction.
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