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Bone mass and bone loss in the elderly: a special case?
1Division of General Internal Medicine, University of California, San Francisco.
International Journal of Fertility and Menopausal Studies
|January 1, 1993
Summary
Elderly individuals experience bone loss, increasing fracture risk. Preventive therapies like calcium and vitamin D show promise for reducing fractures in older adults.
Area of Science:
- Gerontology
- Orthopedics
- Endocrinology
Background:
- Elderly individuals lose bone mass at approximately 1% annually, elevating fracture risk.
- Hip fractures are a major cause of mortality, disability, and healthcare costs, often precipitated by falls.
- Bone remodeling accelerates with age, suggesting antiresorptive therapies may be effective in older populations.
Purpose of the Study:
- To review the effectiveness of preventive therapies for age-related bone loss and fracture risk in the elderly.
- To assess the role of calcium, vitamin D, and estrogen in preventing fractures in older adults.
- To evaluate the utility of bone mass measurements for fracture risk assessment in the elderly.
Main Methods:
- Review of existing literature on bone loss, fracture risk, and preventive therapies in the elderly.
- Analysis of studies on calcium and vitamin D supplementation for bone health in older women.
- Examination of evidence for estrogen's efficacy in preventing vertebral fractures.
- Consideration of fall prevention strategies and bone density measurement utility.
Main Results:
- Calcium supplementation slows bone loss in older women, with combined calcium and vitamin D potentially reducing hip fracture risk in frail elderly individuals.
- Estrogen therapy remains effective in preventing vertebral fractures in older women.
- Preventive therapies offer the most benefit to high-risk individuals: the elderly, those with prior fractures, increased fall risk, or low bone mass.
- Bone mass measurements are likely as useful for fracture risk assessment in the elderly as in younger adults.
Conclusions:
- Antiresorptive therapies are likely effective in the elderly due to increased bone remodeling rates.
- Calcium and vitamin D supplementation, alongside other agents like estrogen, can play a role in fracture prevention in older adults.
- Targeted preventive strategies are crucial for high-risk elderly populations, emphasizing the continued relevance of bone mass measurement.