PSYCHOSOCIAL AND EMOTIONAL IMPACT OF OSTEOPOROSIS
In the elderly, a hip fracture may make an individual four times more likely to die within 3 months. Often times, the injury can cause an increase in comorbid complications resulting in worsened overall health. One in five people with a hip fracture ends up in a nursing home within a year. Many others become isolated, depressed, or frightened to leave home because they fear they will fall (89). Patients with one vertebral fracture are at increased risk of peripheral fracture and further vertebral fracture.
As vertebral height is lost, patients experience discomfort from the rib cage pressing downward on the pelvis. Patients develop a thoracic kyphosis, a lumbar lordosis, and a protuberant abdomen with prominent horizontal skinfold creases. The reduced thoracic space may result in decreased exercise tolerance and reduced abdominal space may give rise to early satiety and weight loss. Sleep disorders may also occur. Patients lose self-esteem. Self-care may become increasingly difficult. Distorted body image and poor health perception may eventually lead to the inability to care for oneself (90).
In the acute phase, adequate management of pain associated with fracture is paramount to reduce symptoms and mobilize the patient. Long-term goals are to maintain or increase skeletal mass and improve mobility and function (90). If not treated adequately, depression may occur as a result of loss of function and chronic pain. Without proper return of function, anxiety regarding fear of falling may be overwhelming and result in a lack of desire for mobility.