Authors (including presenting author) :
Lin KL(1), Leung WT(1), Ho SKS(1), Sin MY(1), Lui BK(1), Chan HL(1), Lee WL(1), Chu KM(1), Chan TS(1), Lam SS(1) , Leung CH(2), Lee YH(3), Mak PK(1), Kng PLC(1)
Affiliation :
(1)Department of Medicine and Geriatric, RTSKH
(2)Department of Physiotherapy, RTSKH
(3)Department of Dietetic, RTSKH
Introduction :
Sarcopenia and osteoporosis are common among older adults. They affect adversely on health, functional independence, and quality of life in older adults; and inevitably imposes heavy burden to the health care system. For these grounds, the “Falls and Bone Health Clinic” at the Geriatric Day Hospital of RTSKH was set up in June, 2019. By early detection and interventions, the clinic strives to keep the muscle and bone of our elderlies “younger” through preventing, delaying, treating, or even reversing sarcopenia and osteoporosis.
Objectives :
1.Evaluate the prevalence of fracture risk of the subjects as well as their risk of sarcopenia
2.Enhance muscle and bone health of the group through the implementation of individualized patient treatment / care plan in lifestyle modification.
Methodology :
Patients with risk of fall / osteoporosis were referred by clinicians to the clinic for assessments and interventions. FRAX tool was used to evaluate fracture risk. Sarcopenia was assessed using the Asia Work Group on Sarcopenia (AWGS) diagnostic criteria, including Bioelectrical impedance analysis (BIA) for skeletal muscle mass. Protocol guided management plan with multidisciplinary input was implemented with recommendations in lifestyle modifications in diet and exercise. Needed cases would receive medical treatment and additional input from physiotherapist and dietitian. Outcomes were evaluated after 6 months on the fall incidents, risk of sarcopenia and compliance to lifestyle modification.
Result & Outcome :
94 patients were recruited to clinic from June 2019 to November 2020 with 87(93%) female, average age of 84 (range 68 – 98), 88(94%) community dwelling. The fall rate was 63.8%(60/94) in one year. 68 patients had FRAX score measured, within which 43(63%) had risk of osteoporotic fracture in 10 years. Prevalence of the group having risk of sarcopenia was 66%(59/90). 6 months after, the fall rate reduced to 22% (12/59, 6-month data); among 34 patients who had BIA measured before and after, 13 patients out of 16 (81.3%) was able to maintain low risk in sarcopenia, and 1 out of 18 (5.5%) improved and passed the BIA test. Among the sample (40) that had obtained pre and post data, more than 40% of the patients were able to maintain healthy life style for bone and muscle health, 30% showed enhancement in lifestyle modifications, such as protein intake and weight bearing exercise.
This pilot program highlighted the importance of the clinic in preserving bone health among the elderlies, and the long term collection of these data may serve as evidences on geriatric sarcopenia and osteoporosis studies, and contribute to the improvement of clinical care in coming future.
