Department of Clinical Pharmacy, School of Pharmacy C238-L15, University of Colorado Denver, Aurora, CO 80045, USA.
Clin Interv Aging. 2009;4:121-36. doi: 10.2147/cia.s4965. Epub 2009 May 14.
The older senior is at high risk for osteoporosis. It is important for healthcare providers to be fully aware of the potential risks and benefits of diagnosing and treating osteoporosis in the older senior population. Data indicate that bone mineral density testing is under-utilized and drug therapy is often not initiated when indicated in this population. Bone mineral density testing with central dual energy x-ray absorptiometry is essential and cost-effective in this population. All older seniors should be educated on a bone-healthy lifestyle including age-appropriate weight-bearing exercise and smoking cessation if necessary. It is important to remember that falls play a very important role in the risk for osteoporotic fractures, especially in the older senior. All older seniors should be evaluated annually for falls and strategies should be implemented to reduce fall risk in this population. The risk for vitamin D insufficiency and deficiency is high in the older senior and can contribute to falls and fractures. Adequate intakes of calcium and vitamin D are important and deficiencies need to be treated. Data on osteoporosis drug therapy in the older senior are lacking. Based on data from subgroup analyses of large osteoporosis trials in postmenopausal women, current osteoporosis therapies appear safe and efficacious in the older senior and most will live long enough to derive a benefit from these therapies. Further studies are needed in older seniors, especially men, to better understand the risks and benefits of pharmacologic therapy for the management of osteoporosis.
老年人骨质疏松风险较高。医疗保健提供者充分了解在老年人群中诊断和治疗骨质疏松症的潜在风险和益处非常重要。数据表明，在该人群中，骨密度测试的利用率较低，且在有指征时，药物治疗往往未被启动。对于该人群，使用中央双能 X 射线吸收仪进行骨密度测试是必要且具有成本效益的。应向所有老年人宣传健康骨骼的生活方式，包括适合年龄的负重运动和必要时戒烟。需要记住的是，跌倒在骨质疏松性骨折的风险中起着非常重要的作用，尤其是在老年人中。所有老年人都应每年评估跌倒风险，并应在该人群中实施降低跌倒风险的策略。老年人中维生素 D 不足和缺乏的风险较高，这可能导致跌倒和骨折。摄入足够的钙和维生素 D 很重要，且需要治疗缺乏症。老年人骨质疏松症药物治疗的数据不足。基于绝经后妇女大型骨质疏松症试验的亚组分析数据，目前的骨质疏松症治疗方法在老年人中似乎是安全且有效的，而且大多数人将有足够的时间从这些治疗中获益。需要在老年人中，特别是男性中进行进一步的研究，以更好地了解药物治疗骨质疏松症的风险和益处。
