'Senile' osteoporosis reconsidered

Article Abstract:

Osteoporosis, a degenerative bone condition marked by the loss of calcium and bone mass, is seen in women of all ages. The condition is most dangerous for the truly elderly. One-quarter of all women over the age of 70 and half of the women over the age of 80 have sustained fractures of the vertebral column as a result of osteoporosis. Fractures of other bones, such as the hip, also plague elderly women. For example, by age 90, one-third of all woman will have sustained a hip fracture. The cost of such fractures to society is estimated to exceed $6 billion per year. In the US, the decreasing birth rate and improvements in longevity have made the elderly the fastest growing segment of the population and, accordingly, the problem of osteoporosis takes on even greater economic and medical importance. Current studies of osteoporosis usually focus on women around the age of menopause (approximately 40-60 years old), and not on the 15 million women over the age of 70. Calcium intake in the elderly is generally low and this dietary problem is enhanced by a reduced ability to absorb it. Endocrine factors and vitamins are also involved. A major increase in parathyroid gland hormone (PTH) and a decrease in vitamin D metabolism occur in the elderly. PTH increases the release of calcium from the bones (bone resorption) and inhibits bone formation, a process which leads to a reduction in bone mass and increased fragility. Reduced turn-over of the bones leads to increased bone age, older bone cells and a loss of bone architecture; these factors also increase the potential for bone fractures. Although bone loss can be prevented in younger postmenopausal women by the use of replacement estrogen (female hormone), there is little evidence that giving estrogen for the first time to older women is effective in increasing bone mass or reducing fractures. One study indicates that the loss of bone mass in 70-year-old women is identical between estrogen-treated and untreated women. Similarly, it is unclear if exercise is effective in reducing osteoporosis in the elderly women. More research is required to fully clarify the underlying factors and treatment for osteoporosis in the aged.

Aged, Elderly, Physiological aspects, Diseases, Vitamin D deficiency

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A 73-Year-Old Woman With Osteoporosis

Article Abstract:

Osteoporosis is a serious disease but it can be prevented and treated. Although bone loss is silent, it can result in fractures. Osteoporosis usually develops after menopause and by old age, many people have lost significant amounts of bone. Sometimes a bone fracture is the first clue. Bone loss can be measured by dual-energy x-ray absorptiometry (DXA), a noninvasive, technique that uses small doses of radiation. Calcium and vitamin D supplements and weight-bearing exercise can prevent bone loss. Once osteoporosis is diagnosed, it can be treated with alendronate, calcitonin, raloxifene or hormone replacement therapy.

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Combination therapy with hormone replacement and alendronate for prevention of bone loss in elderly women: a randomized controlled trial

Article Abstract:

The drug alendronate combined with hormone replacement therapy is more effective than either treatment alone in increasing bone density in elderly women, according to a study of 373 women. The treatment had few side effects and only 10% of the women had to stop the treatment. Increasing bone density can lower a woman's risk of bone fractures.

Evaluation, Hormone therapy, Aged women, Elderly women, Alendronate, Hormone replacement therapy

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