Moro-Alvarez María Jesús, Díaz-Curiel Manuel
Medicina Interna, Unidad de Enfermedades Metabólicas Oseas, Hospital Central Cruz Roja Madrid, Madrid, España.
Rev Esp Geriatr Gerontol. 2010 May-Jun;45(3):141-9. doi: 10.1016/j.regg.2009.11.003. Epub 2010 Jan 29.
Osteoporosis is a progressive skeletal disease characterized by a decrease in bone strength and an increase in the number of fractures. This disease is considered by the World Health Organization to be the second most important health problem in the world after cardiovascular disease. The prevalence of osteoporosis is increasing due to population aging. With age, the loss of bone mass in the spine and hip, which starts at menopause in women and around the age of 60 years in men, continues. Old age is when most fragility fractures occur and the incidence of these fractures is increasing exponentially in persons aged more than 75 years. Several treatments with demonstrated effectiveness in decreasing fracture risk and increasing bone mineral density are currently available for osteoporosis. Nevertheless, the scientific evidence on the safety and efficacy of these treatments is much more scarce in older people than in young populations. There are few reports on the efficacy of these treatments in non-vertebral--specifically hip--fractures in the elderly. Consequently, the present review aims to analyze the scientific evidence on the diagnosis and treatment of osteoporosis, and particularly the evidence on the antifracture efficacy of distinct antiresorptive agents and anabolic drugs in people older than 75 years.
骨质疏松症是一种进行性骨骼疾病，其特征是骨强度降低和骨折数量增加。世界卫生组织认为，这种疾病是仅次于心血管疾病的世界第二大重要健康问题。由于人口老龄化，骨质疏松症的患病率正在上升。随着年龄的增长，脊柱和髋部的骨质流失会持续，女性在绝经后开始，男性在60岁左右开始。老年是大多数脆性骨折发生的时期，这些骨折的发生率在75岁以上的人群中呈指数级增长。目前有几种已证明在降低骨折风险和增加骨矿物质密度方面有效的治疗方法可用于骨质疏松症。然而，与年轻人群相比，关于这些治疗方法的安全性和有效性的科学证据在老年人中要少得多。关于这些治疗方法在老年人非椎体骨折（特别是髋部骨折）中的疗效的报道很少。因此，本综述旨在分析关于骨质疏松症诊断和治疗的科学证据，特别是关于不同抗吸收药物和合成代谢药物在75岁以上人群中的抗骨折疗效的证据。
