Prevention of Fracture Risk among Older Long-term Care Residents: A Prospective Study from India

Abstract

Older adults in long-term care (LTC) facilities are at high risk for fragility fractures due to bone loss, impaired mobility, cognitive decline and polypharmacy. Such fractures increase morbidity, mortality and healthcare costs. This prospective study evaluated the effectiveness of a multifaceted intervention programme for fracture prevention amongst older adults in LTC. A prospective, 24-month interventional study (January 2022–December 2023) was conducted in 10 LTC homes across three districts with 520 residents aged ≥65 years. Outcomes were compared with a matched historical control cohort drawn from the same LTC facilities during 2020–2022, using identical inclusion criteria and outcome definitions. The intervention included Vitamin D and calcium supplementation, structured exercise, medication review, fall prevention strategies and environmental modifications. Fracture incidence, fall rates and functional status were compared to a historical control. Hip and non-hip fractures decreased by 36% and 28%, respectively. Vitamin D supplementation improved serum 25(OH) D levels ( P < 0.01). Exercise enhanced balance and strength ( P < 0.05). Psychotropic use declined by 18% following polypharmacy review. Fall rates dropped by 31%. A comprehensive, multidisciplinary intervention significantly reduced fracture risk in LTC residents, supporting its broader implementation to improve musculoskeletal health and safety in geriatric care.