Issues in Mental Health Nursing, 31:403–407, 2010 Copyright © Informa Healthcare USA, Inc. ISSN: 0161-2840 print / 1096-4673 online DOI: 10.3109/01612840903497594 Survey of Osteoporosis in an Inpatient Geriatric Psychiatric Setting: A Pilot Study Ellen W. Blair, MSN, Bonnie L. Szarek, RN, and Naila Azhar, MD Hartford Hospital, The Institute of Living, Hartford, Connecticut, USA Osteoporosis is a major public health issue. We examined geri- atric psychiatric inpatients’ awareness of having osteopenia and/or osteoporosis. The much lower proportion of our patients reporting a history of osteoporosis suggests that it might be under-diagnosed in this psychiatric population. A high proportion of our sample were treated with psychotropics that may decrease bone mineral density, however, most were not receiving any treatment for os- teoporosis and fewer than expected were aware of a history of osteoporosis. Education of patients about this silent disease should be a priority for psychiatric nurses and the treatment team in an inpatient psychiatric setting. Osteoporosis is a major public health issue. According to the US Surgeon General’s 2004 report, Bone Health and Os- teoporosis (US Department of Health and Human Services [US DHHS], 2004), due to the aging of the population and the previ- ous lack of focus on bone health, the number of hip fractures in the United States could double or triple by the year 2020. The report found that many patients were not being given appropri- ate information about prevention, and many patients were not having appropriate testing to diagnose osteoporosis or establish osteoporosis risk (US DHHS, 2004). Of the 10 million Americans estimated to have osteoporosis, 80% are women. The estimated prevalence of osteoporosis and osteopenia varies by race/ethnicity (see Table 1). When compared with other ethnic/racial groups, risk is in- creasing most rapidly among Hispanic women. Experts predict that costs related to osteoporotic fractures among Hispanics will increase from an estimated $754 million in 2005 to $2 bil- lion per year in 2025. (US DHHS, 2004; National Osteoporosis Foundation, n.d.). Osteoporosis leads to much morbidity and mortality in el- derly people (Stubbs, Zapata-Bravo, & Haw, 2008), with older adults throughout the developed world being at significant risk for osteoporotic fractures (Takkouche, Montes-Martinez, Gill, Address correspondence to Ellen Weiss Blair, Hartford Hospital, The Institute of Living, 200 Retreat Ave, Hartford, CT 06106. E-mail: eblair@harthosp.org & Etminan, 2007). Each year an estimated 1.5 million indi- viduals in the United States suffer an osteoporotic-related frac- ture. In white populations older than 50 years, approximately 50% of women and 20% of men will sustain an osteoporotic fracture in their remaining lifetime. The prevalence is lower in the non-white population. Caucasian women aged 65 or older have twice the incidence of fractures as African-American women (National Osteoporosis Foundation, n.d.). Worldwide, post-menopausal women have a 30–40% lifetime risk for os- teoporotic fractures compared to 13% in men (International Osteoporosis Foundation, 2009). In the United Kingdom, os- teoporosis results in 200,000 fractures a year with an annual cost to the health service of 2.2 billion US dollars (Daly, 2001). In Canada, 20–30% of osteoporotic fractures occur in elderly men, who are more likely to die after a hip fracture than women (International Osteoporosis Foundation, 2009). In the Middle East, the number of hip fractures is expected to triple in the next 20 years (International Osteoporosis Foundation, 2009). Currently, 25% of all hip fractures worldwide occur in Asia and Latin America, and by 2050 this is expected to increase to 50% (International Osteoporosis Foundation, 2009). Fractures caused by osteoporosis and other bone diseases impose tremendous physical and emotional costs on those who suffer them and their family members. They represent a signifi- cant financial burden to both individuals and society at large (US DHHS, 2004). Many of these costs are avoidable, since much is already known about how to effectively prevent, diagnose, and treat bone disease throughout the life span. However, much of what could be done to reduce this burden is not being done today, largely due to a lack of awareness of the problem and the failure to apply current knowledge (Kamel, 2004; Solomon et al., 2003). Although advances have been made in aware- ness, prevention, diagnosis and treatment, osteoporosis remains a silent and underdiagnosed disease for many women. How- ever, osteoporosis is particulatly underdiagnosed in women in racial and ethnic minority groups in the United States. Even though the opportunity for prevention is great, dis- parities in incidence, awareness, diagnosis, treatment and outcomes exist across racial and ethnic lines (Thomas, 2007). 403