The edition · Geriatrics
After a fracture in nursing homes, 73% of residents took fall-risk drugs and 4% took a bisphosphonate
A national snapshot of prescribing after fracture, osteosarcopenia and early cognitive decline, a plant-based diet pattern and frailty, and what resistance training does for executive function in older adults.
The edition in brief
A US cross-sectional study of 192,118 nursing home residents with a recent fracture found that 72.8% had prescriptions for drugs related to injurious falls (statins 31.1%, opioids 26.7%, newer anticonvulsants 22.1%, loop diuretics 22.1%), whereas only 4.2% had an oral bisphosphonate prescription; the authors suggest medication review focusing on opioids and newer anticonvulsants. In 2,291 older adults in Singapore, possible osteosarcopenia (50.3%) was associated with lower intrinsic capacity and poorer cognition six months later. In two Spanish cohorts, higher adherence to a plant-based Planetary Health Diet was associated with lower odds of frailty (pooled OR 0.52, 95% CI 0.38 to 0.70 for highest vs lowest tertile). A meta-analysis of 17 trials found that resistance training improved working memory (SMD 0.30, 95% CI 0.02 to 0.59) and cognitive flexibility (SMD -0.50, -0.88 to -0.12) compared with control in cognitively healthy older adults, but not against other exercise, with low-certainty evidence.
Nursing home residents with a recent fracture: fall-risk drugs were common, bisphosphonates rare
After a fracture, review fall-risk medicines as well as bone treatment: both gaps were large in nursing homes.
Possible osteosarcopenia went with lower intrinsic capacity and poorer cognition at six months
Look for muscle and bone loss together in older adults, and check cognition when you find them.
A plant-based sustainable diet pattern was linked to lower odds of frailty
Higher plant-based diet adherence went with lower frailty odds; use it to support general advice on vegetables and fruit.
Do a medication review, not just a falls review, after every fall
Review medicines and postural blood pressure after every fall.
Resistance training improved working memory and flexibility in cognitively healthy older adults, but not against other exercise
Recommend resistance training for function and falls prevention; any cognitive benefit is possible but unproven and not specific to this exercise type.
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