Osteoporosis: considerations in evaluating and managing the older patient

Osteoporosis is a common disorder that results in 1.3 million fractures each year in the United States. The resultant morbidity and mortality are substantial. While there has been considerable progress in our understanding of this disease, research studies frequently include only early postmenopausal individuals. At the same time, a number of important pathophysiologic and clinical differences exist between early postmenopausal and elderly individuals. These considerations raise the issue of the appropriateness of generalizing evaluation and treatment recommendations from younger to older patients. This review emphasizes factors important in the assessment and treatment of established osteoporosis in older patients.