[Anabolic treatment in geriatric patients with osteoporosis]

Osteoporotic fractures are a major cause of morbidity, functional decline, and mortality in older adults. Despite effective treatment options, a substantial treatment gap persists in primary and secondary fracture prevention. Osteoanabolic agents stimulate bone formation and lead to a rapid improvement in bone mineral density and bone microarchitecture. Clinical trials demonstrate superiority over antiresorptive therapies in patients at very high or imminent risk of fracture; however, treatment in geriatric populations requires a differentiated balancing of the benefit-risk ratio with careful consideration of comorbidities, administration feasibility and cardiovascular safety. This CME article provides a clinically oriented overview of mechanisms of action, efficacy, safety and practical decision strategies for osteoanabolic treatment in older individuals.