High incidence of osteoporosis and fractures in an aging post-polio population

Abstract

Background/aims: Since the polio epidemic in Ireland in the 1950s, most polio survivors are approaching into the 6th and 7th decade of their lives. There is little data about bone density and risk of fractures in these patients. In 2006, we undertook an audit of post-polio patients attending rheumatology and neurology outpatient clinics in a university teaching hospital. Our aim was to determine the prevalence of osteoporosis (OP), falls and fractures and to evaluate the association of bone density with other potential contributing factors to OP.

Methods: Over a 6-month period, 50 post-polio patients attending outpatient clinics completed a questionnaire, and subsequently their medical records were reviewed. Demographic data and details of treatment were extracted. The patients underwent a dual-energy X-ray absorptiometry scanning to quantify bone mineral density.

Results: Thirty subjects (60%) were females (26 were postmenopausal). The average age of females was 60 +/- 13.4 years and of men 59 +/- 16.8 years. Overall, 41 (82%) of the patients had experienced falls in the last 5 years and 32 (64%) in the last 6 months. Nineteen (38%) of the patients had experienced a bone fracture in the last 5 years. Based on the bone mineral density data, 28 (56%) of the patients were diagnosed with OP and 20 (40%) had osteopenia, but only 8 (16%) received anti-resorptive therapy. Of the 19 patients who had a fracture, 14 (74%) had OP and 5 (26%) had osteopenia, of whom only 6 (32%) received anti-resorptive therapy. Eight out of 9 fractures of the neck of femur occurred in the weaker leg.

Conclusions: Post-polio patients are a high-risk group for fracture, and thus bone density assessment, review of falls risk and therapeutic intervention should be considered for all patients. Both osteopenia and OP are associated with increased fracture risk.