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Osteoporosis in the oldest old: epidemiology, assessment, and management 

Osteoporosis in the oldest old: epidemiology, assessment, and management
Chapter:
Osteoporosis in the oldest old: epidemiology, assessment, and management
Author(s):

René Rizzoli

DOI:
10.1093/med/9780198701590.003.0068_update_001

Update:

Deletion of strontium ranelate

Addition of fracture risk in relation to bone microstructure

Extension of vitamin K

Addition of abaloparatide and romosozumab

Substantial change to Table 68.2

Updated on 27 August 2020. The previous version of this content can be found here.
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date: 27 November 2020

Osteoporosis and frailty greatly increase the risk of fracture. Hip fractures are the most serious osteoporotic fractures, with increased risk of mortality. In most countries, the majority are over 80 years old. Large rises on hip and other fragility fracture rates are predicted for much of South America and Asia in the coming decades. The survivors have a high risk of sustaining another major fracture and face deterioration in their quality of life and high risk of dependency. Optimal protein and calcium intakes, and vitamin D supplies, together with regular weight-bearing and balance-improving physical exercise are the cornerstones of fracture prevention. Evidence for antifracture efficacy of pharmacological interventions relies on randomized controlled trials in postmenopausal women between the ages of 50 and 80 years and the evidence of antiosteoporotic efficacy in the oldest old has come primarily from subgroup analyses.

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