Osteoporosis in Older Men: Informing Patient Management and Improving Health-Related Outcomes

Area of Science:

• Gerontology
• Endocrinology
• Orthopedics

Background:

• Osteoporosis is often perceived as a female condition, but men also face significant fracture risks, particularly after age 75.
• Men experiencing fragility fractures have a higher risk of life-threatening complications compared to women.
• Male osteoporosis frequently involves secondary causes and primary risk factors, necessitating comprehensive evaluation.

Purpose of the Study:

• To review the key characteristics of osteoporosis and fragility fractures in men.
• To summarize findings from pharmacological and non-pharmacological studies on male osteoporosis treatment.
• To highlight the importance of timely diagnosis and management in men.

Main Methods:

• Review of existing literature on male osteoporosis.
• Analysis of diagnostic approaches including physical examination, history, laboratory tests, and bone density measurement (dual-energy X-ray absorptiometry).
• Evaluation of treatment strategies, encompassing dietary adjustments, vitamin D supplementation, fall risk reduction, and pharmaceutical interventions.

Main Results:

• Men generally experience fractures about a decade later than women, with risk increasing significantly after 75.
• Dual-energy X-ray absorptiometry is the preferred diagnostic method for osteoporosis in men.
• Bisphosphonates and denosumab are recommended treatments, with anabolic agents considered for high-risk individuals.

Conclusions:

• Male osteoporosis requires dedicated assessment and management strategies.
• Pharmacological treatments effective in women are generally beneficial for men, though specific studies are limited.
• A multimodal approach including lifestyle modifications and medication is essential for reducing fracture risk in men.