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About multiple sclerosis and bone health 

Why is bone health important in MS? 

Individuals with MS are at an elevated risk of developing osteoporosis. This is because people with MS may have risk factors that makes it more likely to develop reduced Bone Mineral Density (BMD). (1, 2)

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MS can cause:

  • Immobility, reduced mechanical loading, vitamin D deficiency, and treatment often involves the use of steroids, all of which can contribute to reduced BMD. (1, 3, 4)

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People with MS also have an increased risk of falls because of symptoms of the condition such as loss of sensation, muscle weakness and visual impairment. (5, 6)

This is why bone health is so important in MS, as osteoporosis and fractures are associated with increased hospitalisation, loss of independence and reduced quality of life. (7) 

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People with osteoporosis have more risk of developing fractures, even from minor injuries or accidents, such as tripping whilst walking, or falling from standing. (7)

  • Osteoporosis is more common in older ages. It is most common in those over 75, with around 20% of people in this age group being affected. (8)

  • In MS, osteoporosis can occur at a younger age.

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Patient undergoing a DXA Scan, the main method of measuring BMD to diagnose osteoporosis.

Current guidelines recommend:

  • Routine bone density screening in all Australians over 70

  • Additional screening for those over 50 with a history of fragility fractures. (9)

 

Unfortunately, this screening program is inadequate for identifying osteoporosis in individuals with MS.

People with MS are often diagnosed at an early age and may then develop osteoporosis in their younger years. This screening gap is a key contributor to the under-detection and treatment of osteoporosis in the MS community. 

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To learn more about our research, click here. 

References:

  1. Bazelier MT, van Staa TP, Uitdehaag BM, Cooper C, Leufkens HG, Vestergaard P, et al. Risk of fractures in patients with multiple sclerosis: a population-based cohort study. Neurology. 2012;78(24):1967-73.

  2. Dobson R, Leddy SG, Gangadharan S, Giovannoni G. Assessing fracture risk in people with MS: a service development study comparing three fracture risk scoring systems. BMJ Open. 2013;3(3).

  3. Bazelier MT, van Staa T, Uitdehaag BM, Cooper C, Leufkens HG, Vestergaard P, et al. The risk of fracture in patients with multiple sclerosis: the UK general practice research database. J Bone Miner Res. 2011;26(9):2271-9.

  4. VanAmerongen BM, Dijkstra CD, Lips P, Polman CH. Multiple sclerosis and vitamin D: an update. Eur J Clin Nutr. 2004;58(8):1095-109.

  5. Ye S, Wu R, Wu J. Multiple sclerosis and fracture. Int J Neurosci. 2013;123(9):609-16.

  6. Su S, Liu H. The association between multiple sclerosis and fracture risk. Int J Clin Exp Med. 2014;7(11):4327-31.

  7. Bisson EJ, Finlayson ML, Ekuma O, Marrie RA, Leslie WD. Accuracy of FRAX((R)) in People With Multiple Sclerosis. J Bone Miner Res. 2019;34(6):1095-100.

  8. Osteoporosis Australian Institute of Health and Welfare; 2020 [updated 2/12/2020. Available from: https://www.aihw.gov.au/getmedia/d89eda49-8e92-4045-996e-f38807142b2e/Osteoporosis.pdf.aspx?inline=true.

  9. Compston A, Coles A. Multiple sclerosis. Lancet. 2008;372(9648):1502-17.

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