Management of osteoporosis in elderly men

Osteoporosis is a common condition associated with aging but has been considered to primarily affect women because of the substantial effect of menopause on osteoporosis. Bone density can decrease with aging in men but occurs more gradually than in postmenopausal women. With improvements in healthcare and extended life expectancy, it is becoming more apparent that osteoporosis affects men and can have serious consequences. Recently, a greater number of osteoporosis studies are either including men or focusing specifically on them. The majority of medication trials in men, however, used bone density as the primary outcome rather than fractures. Therefore, treatment data for men is still rather limited, and there is also very little information in the oldest subset of this population. The more recent guidelines for treating osteoporosis now include men, but the recommendations for screening and treatment are not necessarily gender specific. Despite the limited data, some osteoporosis treatments have received approval to treat or prevent osteoporosis specifically in men. Future studies must provide greater information on fracture prevention in men and also must include a greater population of the oldest geriatric patients, who are typically not well represented in osteoporosis trials, to evaluate any differences in both efficacy and side effects. The oldest group is important because they are at the highest risk for both osteoporosis-related complications and treatment-related adverse events.