Management of Osteoporosis After Fragility Fracture

Case: A 73-year-old female patient, who was an active, healthy retired elementary school teacher, presented to her primary care provider with complaints of anxiety and depression. She is currently being treated for hypertension and osteoarthritis. Her surgical history includes a hysterectomy at the age of 34 years and an internal fixation of the wrist at 69 years. Six months ago, she was treated for a fall after slipping on some ice on her way into the grocery store. She suffered a hip fracture and underwent successful surgical correction. After surgery, the patient spent months in rehab but never fully regained her mobility. The psychological strain of losing her independence was found to significantly contribute to her new diagnoses of anxiety and depression. She felt as though she was a burden to her working daughter, who must now assist with her daily activities. Should we have predicted this outcome for our patient sooner? If so, what could we have done to prevent this outcome?