Stroke is a known risk factor for the development of osteoporosis, leading to an increased risk of falls and fractures. Several international studies have associated stroke with hip fractures, showing an odds ratio ranging between 1.5 and 4. The literature frequently indicates a lack of management for bone metabolism in patients following cerebrovascular events. This study aims to evaluate the incidence of osteoporosis and fragility fractures in patients with chronic stroke. A secondary aim is to assess whether patients have been adequately screened for bone metabolism following a cerebrovascular event. This study is designed as a prospective observational study. Patients aged over 65 years with chronic stroke are assessed at the U.O.C. of "Functional Recovery and Rehabilitation" at A.O.U.P. "P. Giaccone," Palermo. During the assessment, clinical and demographic data are collected, including details of the cerebrovascular event (location, hemorrhagic/ischemic, date), pre-event and post-event disability/autonomy (Rankin scale), presence of fractures (location and date) in the patient's medical history (pre and post-event), femoral and lumbar DEXA for osteoporosis evaluation, and DeFRA for assessing the 10-year risk of fragility fractures.

Inclusion Criteria:

• Patients aged 65 years and older
• Diagnosed with chronic stroke
• Able to provide informed consent
• Willing to participate in follow-up assessments
• Stable medical condition that allows participation in the study

Exclusion Criteria:

• Patients with acute stroke
• Severe cognitive impairment that prevents informed consent
• Other major illnesses affecting bone metabolism (e.g., severe renal disease)
• Patients already undergoing treatment for osteoporosis
• Patients with conditions that contraindicate DEXA scan

Participants will be selected from patients aged 65 and older who have experienced a chronic stroke and are receiving treatment at the Neurology and Rehabilitation Departments of hospitals in Palermo, Italy. The population includes both male and female patients who meet the inclusion criteria and are willing to provide informed consent. The study aims to evaluate the incidence of osteoporosis and fragility fractures in this specific population and to assess their bone metabolism management post-cerebrovascular event.