Osteoporosis workup: evaluating bone loss and risk of fractures

Osteoporosis afflicts millions of Americans, causing an age-related increase in the incidence of fractures of the hip, wrist, spine, and other bones. Older patients require assessment of their fracture risk, including evaluation of skeletal fragility and risk of falls. Secondary causes of bone loss should be sought in individuals with bone density lower than expected for age. Preventive measures, such as supplementary calcium and vitamin D, and environmental changes to decrease the risk of falls in the home are recommended. Physical therapy may decrease the risk of falls and help maintain bone mass. Antiresorptive therapy should be considered for any individual at high risk for fracture, regardless of age.