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Osteoporosis is highly prevalent in frail nursing home residents, but bisphosphonates have not been evaluated extensively in this high-risk population. In this study, 181 women (mean age, 85) with osteoporosis or documented vertebral or hip fractures who were living in long-term care facilities received daily calcium (1200 mg) and vitamin D (800 IU) and were randomized to single intravenous infusions of zoledronic acid (5 mg) or placebo. Most participants had cognitive and functional impairments, were frail, had multiple medical comorbidities, or took several medications.
At 12 months, mean total hip bone-mineral density (BMD) had increased significantly in the intervention group (by 2.8%) and had dropped in the control group (by −0.5%); BMD…