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Scientific article
English

Management of osteoporosis in the elderly

Contributors

Rizzoli, René; Bruyere, O.; Cannata-Andia, J. B.; Devogelaer, J -P; Lyritis, G.; Ringe, J. D.; Vellas, B.; Reginster, J -Y

Published in

Current medical research and opinion, vol. 25, no. 10, p. 2373-2387

Publication date

2009

Abstract

BACKGROUND: Osteoporosis is predominantly a condition of the elderly, and the median age for hip fracture in women is approximately 83 years. Osteoporotic fracture risk is multifactorial, and often involves the balance between bone strength and propensity for falling. OBJECTIVE: To present an overview of the available evidence, located primarily by Medline searches up to April, 2009, for the different management strategies aimed at reducing the risk of falls and osteoporotic fractures in the elderly. RESULTS: Frailty is an independent predictor of falls, hip fractures, hospitalisation, disability and death in the elderly that is receiving increasing attention. Non-pharmacological strategies to reduce fall risk can prevent osteoporotic fractures. Exercise programmes, especially those involving high doses of exercise and incorporating balance training, have been shown to be effective. Many older people, especially the very elderly and those living in care institutions, have vitamin D inadequacy. In appropriate patients and given in sufficient doses, vitamin D and calcium supplementation is effective in reducing both falls and osteoporotic fractures, including hip fractures. Specific anti-osteoporosis drugs are underused, even in those most at risk of osteoporotic fracture. The evidence base for the efficacy of most such drugs in the elderly is incomplete, particularly with regard to nonvertebral and hip fractures. The evidence base is perhaps most complete for the relatively recently introduced drug, strontium ranelate. Non-adherence to treatment is a substantial problem, and may be exacerbated by the requirements for safe oral administration of bisphosphonates. CONCLUSION: Evidence-based strategies are available for reducing osteoporotic fracture risk in the elderly, and include exercise training, vitamin D and calcium supplementation, and use of evidence-based anti-osteoporotic drugs. A positive and determined approach to optimising the use of such strategies could reduce the burden of osteoporotic fractures in this high-risk group.

Keywords

  • Accidental Falls
  • Aged
  • Aged, 80 and over
  • Evidence-Based Medicine
  • Exercise
  • Fractures, Bone/prevention & control
  • Frail Elderly
  • Humans
  • Osteoporosis/*therapy
  • Postural Balance
  • Risk Factors

UNIGE affiliation entities

UNIGE research groups

Citation (ISO format)

RIZZOLI, René et al. Management of osteoporosis in the elderly. In: Current medical research and opinion, 2009, vol. 25, n° 10, p. 2373–2387. doi: 10.1185/03007990903169262

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Journal ISSN

0300-7995
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Technical informations

Creation

23/04/2012 13:32:06

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23/04/2012 13:32:06

Update

14/03/2023 17:27:26

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