A new study from University College London (UCL) reveals that individuals over 50 with severe mental illness (SMI) face a significantly higher risk of fragility fractures compared to the general population, yet they may be less likely to receive a diagnosis of osteoporosis.
Fragility fractures, which occur from minor falls or impacts that would typically not cause a break, are commonly associated with osteoporosis—a condition that weakens bones and increases fracture susceptibility.
Published in the British Journal of General Practice, the research analyzed general practitioner (GP) records of over 440,000 individuals aged 50 and older from 2000 to 2018. The study aimed to evaluate the rates of osteoporosis diagnoses and fragility fractures in individuals with a prior diagnosis of severe mental illness compared to their peers without such diagnoses.
Severe mental illness encompasses serious mental health conditions like schizophrenia, bipolar disorder, and other forms of psychosis. These disorders often severely affect a person’s daily functioning and ability to work.
Individuals with SMI frequently experience poor physical health and tend to develop chronic conditions, including obesity, asthma, diabetes, chronic obstructive pulmonary disease (COPD), coronary heart disease, stroke, heart failure, and liver disease, at younger ages than those without SMI. Moreover, they are at an increased risk of developing multiple chronic health issues simultaneously.
The study’s findings indicated that a diagnosis of severe mental illness significantly correlated with an increased risk of fragility fractures for both men and women. However, the results highlighted that men with SMI were twice as likely to have a documented history of fragility fractures than osteoporosis diagnoses. This suggests a potential underdiagnosis of osteoporosis in men with severe mental illness.
Similarly, among women aged 50 to 54 and those over 80 with severe mental illness, records showed a greater likelihood of fragility fractures than osteoporosis diagnoses, indicating that osteoporosis may also be underidentified in these groups.
In light of these findings, the researchers advocate for targeted interventions, such as bone density assessments, osteoporosis treatments, and non-pharmacological strategies like exercise and dietary recommendations, for individuals with severe mental illness.
While the study did not delve into the underlying causes of these findings, Dr. Christina Avgerinou, the lead author and an academic GP at UCL, noted that various factors could contribute to this trend.
This research was funded by the National Institute for Health and Care Research (NIHR) and the School for Primary Care Research, with adoption by NIHR Applied Research Collaboration (ARC) North Thames.
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