Authors: Karnik, Ankur A; von Feldt, Joan M

Source: Aging Health, Volume 4, Number 4, August 2008 , pp. 351-363(13)

Publisher: Future Medicine

Abstract:

The economic, social and personal burdens of osteoporosis carry a heavy toll. Despite this, it is significantly under-recognized and under-treated. Complete evaluation includes work-up and recognition of secondary causes of osteoporosis in addition to biochemical marker and bone densitometry testing. Recognition of factors contributing to falls is a critical part of prevention of fragility fractures in the elderly. Nutraceutical treatments include calcium and vitamin D. Pharmacologic treatments include bisphosphonates, raloxifene, estrogen, testosterone, strontium ranelate, calcitonin and parathyroid hormone (recombinant 1--34 and 1--84). Although bisphosphonates are generally considered first-line therapy, therapies such as raloxifene and zoledronate have unique benefits. Nonpharmacologic interventions include weight-bearing exercise and behavioral counseling for modification of risk factors such as smoking and alcohol use. Fall and fracture prevention with hip protectors and balance training have also been used. The ideal duration of therapy is not well established. Treatment failure should raise concerns about compliance and secondary causes of fractures/osteoporosis.

Keywords: bisphosphonate; elderly; falls; fracture; osteoporosis

Document Type: Research article

DOI: http://dx.doi.org/10.2217/1745509X.4.4.351

Affiliations: 1: 1Philadelphia Veterans Affairs Medical Center Department of Medicine, 3900 Woodland Avenue, Philadelphia, PA 19104, USA., Email: ankur.karnik@uphs.upenn.edu

Publication date: 2008-08-01

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• Aging Health leading coverage of current and emerging topics relating to the safe and effective management of therapy in the elderly, all subject to rigorous peer review. The journal focuses on the most important advances and highlights their relevance in the clinical setting. The journal has been designed to deliver essential concise information in an easily assimilable format - vital for the increasingly time-constrained professional.
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