Peer Reviewed
Feature Article Endocrinology and metabolism

Osteoporosis in the very old

Oyekoya T Ayonrinde, Leon Flicker
Abstract
Osteoporosis is a common but underdiagnosed and undertreated condition in very old patients. The deformity, morbidity and loss of independence experienced after an osteoporotic fracture is a major health concern in this population.
Key Points
  • Osteoporosis is a common chronic bone disorder signifying bone failure. It frequently manifests as fragility or minimal trauma fractures.
  • Osteoporosis is underdiagnosed and undertreated in the very old, particularly in the most frail. Chronological age alone should not disqualify very old patients from treatment.
  • Many older people will be diagnosed with osteoporosis after a fracture has occurred. The recovery phase is an ideal time to consider the diagnosis as well as strategies for preventing fractures in future.
  • Recognition of risk factors for osteoporosis and falls should help identify the most appropriate intervention for individual patients.
  • Specific pharmacotherapy for osteoporosis in very old patients includes calcium and vitamin D supplements, bisphosphonates and raloxifene. Lifestyle factors should be addressed in all patients.
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