Evaluation of bone fragility in cognitively or physically impaired elderly care home patients using radiofrequency echographic multi-spectrometry

Dual-energy X-ray absorptiometry (DXA) is the standard for bone mineral density (BMD) assessment but is often inaccessible to cognitively or physically impaired care home patients. Radiofrequency echographic multi-spectrometry (REMS), a portable and radiation-free alternative, enables effective BMD evaluation in this vulnerable and underserved population. This cross-sectional study assessed BMD using REMS in 260 patients aged ≥ 70 years (39 males, 221 females; mean age 82.29 years) between April 2023 and July 2024. Osteoporosis diagnosis was based on T-scores < - 2.5 SD or history of fragility fractures, with severe osteoporosis defined by WHO criteria and high fracture risk by lumbar T-scores < - 3.3 SD. Care home patients had significantly lower BMD and T-scores than outpatients, with 56.3% diagnosed with severe osteoporosis and 71.8% exhibiting lumbar T-scores < - 3.3 SD. Despite high fracture risks, only 12.7% of care home patients received treatment. These trends were consistent across all age groups, revealing a high prevalence and severity of osteoporosis in care home residents. REMS has unveiled a substantial treatment gap in this population, emphasizing the critical need for improved osteoporosis management and proactive interventions to reduce fracture risks among care home patients worldwide.