[Osteoporosis in the elderly--diagnosis and treatment].
In contrast to postmenopausal osteoporosis, the overriding objective in senior citizens older than 75 years is to avoid fractures of the hip, which are associated with a high mortality rate. Bone density measurement obtained at the neck of the femur using DXA provides reliable data on the risk of an individual patient of sustaining a fracture close to the hip joint. A physical examination can help to assess the patient's risk of falling, while diagnostic laboratory studies can help to exclude secondary osteoporosis. As a preventive measure, physical activity can increase bone density also in old age. Calcium and vitamin D improve muscular strength and coordination, and thus also may be helpful in preventing falls. In manifest osteoporosis, risedronate and alendronate reduce the risk of fractures close to the hip and of vertebrae by 50%. In addition, raloxifene can be employed to prevent vertebral fractures.
Gärtner
Roland
R
Medizinische Klinik Innenstadt der Universität München. roland.gaertner@med.uni-muenchen.de
D000058:Accidental Falls; D000367:Age Factors; D000369:Aged, 80 and over; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D004164:Diphosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D012968:Etidronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D015444:Exercise; D005260:Female; D006620:Hip Fractures / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000188:drug therapy; D017410:Practice Guidelines as Topic; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use; D000068296:Risedronic Acid; D012307:Risk Factors; D012737:Sex Factors; D016103:Spinal Fractures / Q000209:etiology / Q000517:prevention & control; D014807:Vitamin D / Q000627:therapeutic use
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D014807:Vitamin D; D020849:Raloxifene Hydrochloride; D000068296:Risedronic Acid; D012968:Etidronic Acid; D002118:Calcium