Endocrine Conditions in Older Adults: Osteoporosis

Area of Science:

• Bone health and osteoporosis management
• Pharmacological and non-pharmacological interventions
• Clinical decision support systems

Background:

• Osteoporosis management has significantly evolved over two decades due to technological advancements and new therapeutic options.
• Discrepancies exist in international practice guidelines for osteoporosis screening, prevention, and management strategies.
• Early life prevention through nutrition and exercise is crucial, alongside continuous risk factor evaluation in older adults.

Observation:

• Bone mineral density testing, vertebral fracture assessment, and trabecular bone scores have improved fracture risk identification.
• Emerging decision support tools aid in identifying high-risk individuals for osteoporosis.
• Secondary risk factors, including comorbidities and medications, require ongoing assessment and management.

Findings:

• Current osteoporosis management includes lifestyle interventions and pharmacotherapies like bisphosphonates, denosumab, and parathyroid hormone analogs.
• Treatment selection hinges on efficacy, adverse effect profiles, cost, and individual patient characteristics.
• Long-term pharmacotherapy benefits are recognized, but risks such as atypical fractures and osteonecrosis of the jaw exist.

Implications:

• Further research is needed to clarify optimal pharmacotherapy duration for osteoporosis.
• Personalized medicine approaches are essential for tailoring osteoporosis treatment strategies.
• Continued advancements in screening and decision support tools will enhance patient outcomes in osteoporosis care.