Efficacy of Comprehensive Management Protocol for Improvement of Bone Health in Elderly Osteoporotic Individuals Attending a Tertiary Care Centre Hospital in Kolkata, India
DOI:
https://doi.org/10.31674/mjn.2025.v16i04.025Abstract
Background: Osteoporosis is a growing public health concern, especially among the elderly population in India. There is a dearth of studies evaluating the role of multimodal treatment for the improvement of bone health apart from pharmaceutical management in India. In this study, an attempt was made to improve bone health using comprehensive multimodal management, compared to conventional pharmaceutical management, specific nutrition, and diet. Methods: A total of 130 patients diagnosed with osteoporosis (T score –2.5 or below by Quantitative Ultrasound Scan, QUS), aged between 50 to 80 years, were selected for the study. All participants were receiving standard pharmaceutical treatment along with specific nutrition and diet prescribed by their treating physician. They were randomly divided into two groups of 65 each: the control group continued with standard treatment, while the experimental group received comprehensive management (including standard care, muscle-building exercises, and environmental/lifestyle modifications). Data were collected from 58 participants in each group. Bone Mineral Density (BMD) was measured via QUS at baseline on the 6th months and 12th months, with follow-up at 3 and 9 months via telephonic interview, mainly for supervision. Statistical analysis was performed using the Mann-Whitney U test. Results: At baseline, median BMD T score was –2.5 (control) vs –2.6 (experimental) (p=0.08), indicating homogeneity. At 6 months, it remained –2.6 (control) vs improved –2.5 (experimental) (p=0.02). At 12 months, the score was –2.6 (control) vs –2.5 (experimental) with p=0.001, suggesting significant improvement in the experimental group. Conclusion: A supervised, comprehensive multimodal management protocol offers a cost-effective and practical adjunct to conventional pharmacological treatment. It significantly enhances bone health and BMD outcomes in elderly patients with osteoporosis.
Keywords:
Bone Health, Elderly Care, Nurses, OsteoporosisDownloads
References
Agostini, F., de Sire, A., Sveva, V., Finamore, N., Savina, A., Fisicaro, A., ... & Paoloni, M. (2024). Rehabilitative good clinical practice in the treatment of osteoporosis: A comprehensive review of clinical evidences. Disability and Rehabilitation, 1-15. https://doi.org/10.1080/09638288.2024.2440142
Anish, R. J., & Nair, A. (2024). Osteoporosis management-current and future perspectives - A systemic review. Journal of Orthopaedics, 53, 101–113. https://doi.org/10.1016/j.jor.2024.03.002
Anupama, D. S., Noronha, J. A., Acharya, K. K. V., Prabhu, M., Ravishankar, N., & Nayak, B. S. (2023). Effect of lifestyle modification intervention programme on bone mineral density among postmenopausal women with osteoporosis. Sultan Qaboos University Medical Journal, 23(3), 387–393. https://doi.org/10.18295/squmj.1.2023.010
Bhattarai, A. (2024). Knowledge and preventive practice regarding osteoporosis among women residing in Barahakshetra municipality, Sunsari (Doctoral dissertation, Department of Nutrition & Dietetics Central Campus of Technology Institute of Science and Technology Tribhuvan University, Nepal. 2021). Retrieved from: http://202.45.146.37:8080/jspui/handle/123456789/405 . Accessed on 30th October, 2024.
Cooper, C., Rizzoli, R., & Reginster, J. Y. (2009). The International Osteoporosis Foundation: history, objectives and achievements. Osteoporosis International: A journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 20 Suppl 3, S241–S242. https://doi.org/10.1007/s00198-008-0700-5
Curtis, E. M., Woolford, S., Holmes, C., Cooper, C., & Harvey, N. C. (2020). General and specific considerations as to why osteoporosis-related care is often suboptimal. Current Osteoporosis Reports, 18(1), 38–46. https://doi.org/10.1007/s11914-020-00566-7
Deng, X., Xu, X., Shi, L., Zhang, H., Guo, X., & Liu, Y. (2025, April 3). Effect of a multidisciplinary team intervention program for older adults with osteoporosis in the community: A randomized controlled trial (Version 1) [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-6268320/v1
Dent, E., Daly, R. M., Hoogendijk, E. O., & Scott, D. (2023). Exercise to prevent and manage frailty and fragility fractures. Current Osteoporosis Reports, 21(2), 205–215. https://doi.org/10.1007/s11914-023-00777-8
Eastell, R., Rosen, C. J., Black, D. M., Cheung, A. M., Murad, M. H., & Shoback, D. (2019). Pharmacological management of osteoporosis in postmenopausal women: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 104(5), 1595-1622. https://doi.org/10.1210/jc.2019-00221
Elam, R. E. W., & Jackson, N. N. (2024, January 8). Osteoporosis. Medscape website. https://emedicine.medscape.com/article/330598-overview. Accessed on 10th October, 2024.
Hans, D., & Baim, S. (2017). Quantitative Ultrasound (QUS) in the Management of Osteoporosis and Assessment of Fracture Risk. Journal of clinical densitometry: The official journal of the International Society for Clinical Densitometry, 20(3), 322–333. https://doi.org/10.1016/j.jocd.2017.06.018
Khinda, R., Valecha, S., Kumar, N., Walia, J. P. S., Singh, K., Sethi, S., Singh, A., Singh, M., Singh, P., & Mastana, S. (2022). Prevalence and Predictors of Osteoporosis and Osteopenia in Postmenopausal Women of Punjab, India. International Journal of Environmental Research and Public Health, 19(5), 2999. https://doi.org/10.3390/ijerph19052999
Lata, H., & Kaur, S. (2023). A study to assess the effectiveness of planned teaching programme on menopausal osteoporosis and its prevention among perimenopausal women in selected area of district Chamba, Himachal Pradesh. International Journal of Creative Research Thoughts (IJCRT), 11(3), 350–354. Retrieved from: https://www.ijcrt.org/papers/IJCRT2303387.pdf. Accessed on 24th July, 2024.
Lee, D. O., Hong, Y. H., Cho, M. K., Choi, Y. S., Chun, S., Chung, Y. J., Hong, S. H., Hwang, K. R., Kim, J., Kim, H., Lee, D. Y., Lee, S. R., Park, H. T., Seo, S. K., Shin, J. H., Song, J. Y., Yi, K. W., Paik, H., & Lee, J. Y. (2024). The 2024 Guidelines for Osteoporosis - Korean Society of Menopause: Part I. Journal of Menopausal Medicine, 30(1), 1–23. https://doi.org/10.6118/jmm.24000
Mineiro, L., Zeigelboim, B. S., dos Santos, C. F., da Rosa, M. R., Valderramas, S., & Gomes, A. R. S. (2024). Effects of exercise for older women with osteoporosis: A systematic review. Molecular & Cellular Biomechanics, 21, 117-117. https://doi.org/10.62617/mcb.v21.117
Muhamad Jamil, N. K., Naina Mohamed, I., Mokhtar, S. A., Leong, J. F., Kamudin, N. A. F., & Muhammad, N. (2024). Barriers to osteoporosis management and adherence to Clinical Practice Guideline: a comparative study between tertiary East Coast hospitals and a Fracture Liaison Services (FLS)-accredited hospital in Malaysia. Archives of Osteoporosis, 19(1). https://doi.org/10.1007/s11657-024-01407-1
Nielsen, B. R., Abdulla, J., Andersen, H. E., Schwarz, P., & Suetta, C. (2018). Sarcopenia and osteoporosis in older people: a systematic review and meta-analysis. European Geriatric Medicine, 9(4), 419–434. https://doi.org/10.1007/s41999-018-0079-6
Nuti, R., Brandi, M. L., Checchia, G., Di Munno, O., Dominguez, L., Falaschi, P., Fiore, C. E., Iolascon, G., Maggi, S., Michieli, R., Migliaccio, S., Minisola, S., Rossini, M., Sessa, G., Tarantino, U., Toselli, A., & Isaia, G. C. (2019). Guidelines for the management of osteoporosis and fragility fractures. Internal and Emergency Medicine, 14(1), 85–102. https://doi.org/10.1007/s11739-018-1874-2
Rentzeperi, E., Pegiou, S., Tsakiridis, I., Kalogiannidis, I., Kourtis, A., Mamopoulos, A., Athanasiadis, A., & Dagklis, T. (2023). Diagnosis and management of Osteoporosis: A comprehensive review of guidelines. Obstetrical & Gynecological Survey, 78(11), 657–681. https://doi.org/10.1097/OGX.0000000000001181
Siffert, R. S., & Kaufman, J. J. (2007). Ultrasonic bone assessment: "the time has come". Bone, 40(1), 5–8. https://doi.org/10.1016/j.bone.2006.07.018
Tucci, J. R. (2006). Importance of early diagnosis and treatment of osteoporosis to prevent fractures. American Journal of Managed Care, 12(7), 181–190. Retrieved from: https://www.ajmc.com/view/may06-2313ps181-s190 . Accessed on 14th June, 2024.
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