Research Description

Funded consecutively by the Health Research Board (HRB), our research addresses major challenges in Irish osteoporosis care. DXA (Dual-energy X-ray Absorptiometry) is the gold standard diagnostic tool. National data on prevalence and fracture risk were unknown as Ireland lacks a screening programme. Partnering with three healthcare centres, we provided the first national estimates of osteoporosis prevalence, major osteoporotic fracture (MOF) incidence, and clinical tool validation using DXA [1]. Our findings show osteoporosis is more prevalent than previously reported, especially in older adults, emphasising the need for earlier diagnosis, intervention, and national policy action.

1 in 3 men and 1 in 5 women die within a year of a hip/spine fracture. Fracture-related healthcare costs reached €1 billion (2020), projected to double by 2030. Research shows up to 50% of fractures are preventable with proper screening/treatment.

Using DXA-data integrated with hospital-data from 2001–2024, we developed and fully validated (internally and externally) the DXA-MAP tool, a clinical tool that estimates osteoporosis risk in just three seconds [journal paper forthcoming].

International evidence supports targeted DXA screening, which measures bone strength to help detect osteoporosis and prevent fractures before they occur. Although validated elsewhere, we were the first to validate the OSTi (Osteoporosis Self-assessment Tool Index) in Ireland, showing its potential to improve screening efficiency [2]. Our research also highlights the potential of machine learning and deep learning to classify and predict osteoporosis [3] and bone mineral density (BMD) [4], validating it for diagnosing osteoporosis in Ireland and enhancing early detection and risk stratification.

We found that 1 in 6 people with Rheumatoid Arthritis has a major osteoporotic fracture, highlighting the importance of checking bone strength in this high-risk group [5]. Our results also show that hip bone density in Irish adults is similar to international reference data, making it reliable for diagnosing osteoporosis [6].

Alongside diagnostic advancements, our research also focused on improving physical outcomes and confidence for those living with osteoporosis. We developed a novel clinical intervention incorporating augmented reality (AR) exergames. We conducted a Clinical Trial where 41 participants (aged 60-86y) completed twice-weekly, six-week sessions of 25minutes duration/session. The intervention group used the AR exergame training; the control group performed traditional exercises. Both groups improved in pain, strength, and flexibility, with the osteoporosis therapy [journal paper forthcoming].

Our research supports a national screening programme that could eliminate >€100 million in unnecessary testing and treatment annually, improving patient outcomes and clinical efficiency.