Recent Advances in Geriatric Medicine

Volume: 1

Chronic Diseases in Geriatric Patients

Indexed in: EBSCO.

The incidence of multiple chronic diseases affecting a single individual is common among elderly patients. This incidence is believed to be associated with a decline in many health outcomes, ...
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Towards Unbreakable Old Bones: Osteoporosis in Older Adults

Pp. 155-173 (19)

Kareeann Sok Fun Khow and Tuck Yean Yong

Abstract

Osteoporosis is characterised by bone demineralisation, reduction in bone mass and changes in bone micro-architecture or the presence of a fragility fracture. Osteoporosis is still frequently underdiagnosed and undertreated. Advancing age is a risk factor for underdiagnosis and undertreatment of osteoporosis. The goal of treatment is to reduce morbidity and mortality associated with the first fracture and prevent subsequent fractures. Osteoporosis management in older adults (≥65 years of age) must involve both non-pharmacological and pharmacological interventions. Beneficial non-pharmacological interventions include falls risk assessment and management, participation in exercise programs and the use of hip protectors. Pharmacological treatments including calcium, vitamin D, bisphosphonates, denosumab, strontium and teriparatide are generally safe for use in older people and significantly reduce fracture risk especially vertebral fractures. However the evidence is not as strong for reducing the risk in non-vertebral and hip fractures.

Keywords:

Bisphosphonate, Bone loss, Calcium, Denosumab, Falls prevention, Fractures, Older people, Osteoclast, Osteoporosis, Parathyroid hormone, Strontium, Vitamin D.

Affiliation:

Aged and Extended Care Services, The Queen Elizabeth Hospital and Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia.