Among the more than 1.5 million Americans who live in nursing homes,1 most are older than 65 years and, by standard national
definitions, receive intermediate and skilled care. Many have dementia, incontinence,
and physical disabilities, as well as major chronic illnesses such as heart
disease, cancer, degenerative arthritis, stroke, and other neurological conditions.
As a few studies have demonstrated,2,3
low bone mineral density (BMD) and osteoporosis are highly prevalent in this
population. Prevalence rates for osteoporosis, as defined by World Health
Organization criteria, have been reported in up to 80% to 85% of these individuals:
that is, BMD levels at various anatomic sites, particularly the femoral neck,
at least 2.5 SDs below the mean for young adults.4
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