Sfeir Jad G, Pignolo Robert J
Robert and Arlene Kogod Center on Aging Mayo Clinic Rochester MN USA.
Division of Endocrinology Diabetes, Metabolism, and Nutrition, Mayo Clinic Rochester MN USA.
JBMR Plus. 2021 Sep 5;5(10):e10538. doi: 10.1002/jbm4.10538. eCollection 2021 Oct.
With an increasingly older population, the proportion of patients 85 years or older seeking interventions to protect their musculoskeletal health is growing. Osteoporosis in the geriatric population presents unique diagnostic and therapeutic challenges. Multimorbidity, frailty, falls, polypharmacy, and other neurobehavioral factors influence our approach to fracture prevention in this population. The vast majority of the evidence from clinical trials establish pharmacologic fracture efficacy in postmenopausal women. The evidence is scarce for the oldest old men and women, a population also at risk for adverse events and mortality. Most studies show continued efficacy of pharmacologic interventions in this age group, although they are largely limited by small sample sizes. We herein review the available evidence of pharmacologic interventions for fracture risk reduction in this population and explore the emerging senotherapeutic interventions in the pipeline. © 2021 The Authors. published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
随着人口老龄化日益加剧，寻求干预措施以保护肌肉骨骼健康的85岁及以上患者比例不断增加。老年人群中的骨质疏松症带来了独特的诊断和治疗挑战。多种疾病共存、身体虚弱、跌倒、多重用药以及其他神经行为因素影响着我们对该人群骨折预防的处理方式。临床试验的绝大多数证据确立了药物在绝经后女性中的骨折预防疗效。对于高龄男性和女性，这一人群同样面临不良事件和死亡风险，相关证据却很匮乏。大多数研究表明，药物干预在该年龄组持续有效，尽管大多受限于样本量较小。我们在此回顾了该人群中降低骨折风险的药物干预现有证据，并探讨了正在研发的新兴衰老治疗干预措施。© 2021作者。由Wiley Periodicals LLC代表美国骨与矿物质研究学会出版。
