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Feature Article

Osteoporosis in older people – managing the risks

CHARLES A. INDERJEETH, WENDY HARROD, ANDRISHA J. INDERJEETH

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© STEVEDEBENPORT/ ISTOCKPHOTO.COM MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY

Abstract

Osteoporosis increases with age and people aged over 70 years are at high risk of nonvertebral and hip fractures. Management should be multifactorial and needs to consider the triad of osteoporosis, falls risk and the impact of a fall in older people. Pharmacological treatment can aid with increasing bone density, but adherence is key.

Key Points

  • Older people are at highest risk of minimal trauma fracture, requiring a multifactorial and multidisciplinary approach to fracture reduction.
  • Bone mineral density testing is essential to screen for osteoporosis in this population.
  • It is essential to address the triad of osteoporosis, falls risk and the impact of falls in older people.
  • Safe mobility and exercise with appropriate supervision should be encouraged, and nutrition, calcium intake and vitamin D levels optimised.
  • Osteoporosis medications can be chosen based on patient preferences to optimise adherence.
  • Use of hip protectors should be encouraged, as the risk of falls-associated hip fracture cannot be abolished in most older people.

Figures

© STEVEDEBENPORT/ ISTOCKPHOTO.COM MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY
© STEVEDEBENPORT/ ISTOCKPHOTO.COM MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY