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Prevention of Hip Fracture in Elderly Women With Alzheimer Disease
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In reference to the interesting trial by Sato and collegues,1 we would like to raise the following issues. According to the US National Osteoporosis Foundation guidelines, hip bone mineral density (BMD) is the best predictor of hip fractures.2 Use of metacarpal BMD measurement in the study may have preselected a group of individuals at slightly different risk for hip fractures. The severity of dementia in patients with Alzheimer disease3 and osteoporosis4 may have influenced their predisposition to fractures. Therefore, it will be useful to perform a stratified analyses based on degree of severity of preexisting osteoporosis and dementia. Also, the level of physical activity is linked with BMD.5 It will be informative to examine the level of daily physical exercise of the study subjects, as it may be a potential confounder of the results.
Finally, the dietary intake of calcium and vitamin D availability from sun exposure varies by the . . . [Full Text of this Article]
AUTHOR INFORMATION
Balavenkatesh Kanna, MD, MPH;
Estrella Roffe, MD
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Prevention of Hip Fracture in Elderly Women With Alzheimer Disease—Reply
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Arch Intern Med. 2006;166(10):1145.
EXTRACT
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The Prevention of Hip Fracture With Risedronate and Ergocalciferol Plus Calcium Supplementation in Elderly Women With Alzheimer Disease: A Randomized Controlled Trial
Yoshihiro Sato, Tomohiro Kanoko, Kei Satoh, and Jun Iwamoto
Arch Intern Med. 2005;165(15):1737-1742.
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