Reference : Management of osteoporosis in the elderly.
Scientific journals : Article
Human health sciences : General & internal medicine
http://hdl.handle.net/2268/20297
Management of osteoporosis in the elderly.
English
Rizzoli, René [> > > >]
Bruyère, Olivier mailto [Université de Liège - ULg > Département des sciences de la santé publique > Epidémiologie et santé publique - Département des sciences de la santé publique >]
Cannata-Andia, Jorge Benito [> > > >]
Devogelaer, Jean-Pierre [> > > >]
Lyritis, G. [> > > >]
Ringe, J. D. [> > > >]
Vellas, B. [> > > >]
Reginster, Jean-Yves mailto [Université de Liège - ULg > Département des sciences de la santé publique > Epidémiologie et santé publique >]
2009
Current Medical Research & Opinion
LibraPharm Ltd
25
10
2373-2387
Yes (verified by ORBi)
International
0300-7995
1473-4877
Newbury Berkshire
United Kingdom
[en] 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.
http://hdl.handle.net/2268/20297
10.1185/03007990903169262

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