The risks for falls and fractures in multiple sclerosis

@article{Tremlett2012TheRF,
  title={The risks for falls and fractures in multiple sclerosis},
  author={Helen Tremlett and Robyn M. Lucas},
  journal={Neurology},
  year={2012},
  volume={78},
  pages={1902 - 1903}
}
Fractures, particularly hip fractures, are a major public health issue, being associated with high morbidity and mortality.[1][1] Less than half of all hip fracture patients will ever fully recover ability to perform basic activities of daily living.[1][1] A number of the risk factors for falls and 
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Fractures and falls in patients with newly diagnosed clinically isolated syndrome and multiple sclerosis and several sclerosis are studied. Expand
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TLDR
Treatment for a patient with a fractured hip focuses on getting the patient back to the preinjury activity level and the timing of internal fixation in relationship to morbidity has been studied and concluded that patients with one or two comorbidities received the best outcome if they received internal fixation within 2 days from the time of injury. Expand
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Increased awareness of the risk of hip fracture is warranted in patients with MS, especially in those who have recently been prescribed antidepressants or hypnotics/anxiolytics. Expand
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Antiresorptive therapy with bisphosphonates and optimising vitamin D levels are likely to be effective interventions although there are no randomised studies of this therapy. Expand
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Fractures occurred more often in patients with MS, especially fractures of the tibia, hip and femur, which were elevated in MS patients versus controls. Expand
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TLDR
It is concluded that MS is associated with an increased risk of fracture. Expand
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The group of other antidepressants did not seem to be systematically associated with fractures, although a small increase may be seen for some types early after initiation, and the alterations in risk of fractures were small. Expand
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Among older community-dwelling women, annual oral administration of high-dose cholecalciferol resulted in an increased risk of falls and fractures. Expand
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TLDR
Uncertainty remains about the efficacy of regimens which include Vitamin D or its analogues in fracture prevention, and further randomised trials with economic evaluation are desirable before community fracture prevention programmes employing Vitamin D supplementation can be confidently introduced. Expand
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The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians, including PIER (Physicians’ Information and Education Resource) and MKSAP (Medical Knowledge and Self Assessment Program). Expand
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