Abstract
Osteoporosis is defined by the WHO as bone densitometry derived T-scores being ≤2.5 at the lumbar spine or the hip. Osteoporosis should be ascertained by DXA in individuals with a risk factor of osteoporosis including a history of fracture, low body weight, parental history of hip fracture, use of glucocorticoids, in conditions with bone adverse effects (hypogonadism, hyperthyroidism, hyperparathyroidism, chronic inflammatory diseases, hypopituitarism, use of Gonadotropin-releasing hormon (GnRH) agonists and aromatase inhibitors), and in older patients at high risk of falling. Osteoporosis drugs should be considered after a careful assessment of the benefit/risk ratio in patients at high risk of fracture, i.e., with a fragility fracture or a densitometry confirmed osteoporosis. Oral bisphosphonates are initial agents in older people. Subcutaneous denosumab, teriparatide, or intravenous zoledronic acid may be considered as second-line therapy.
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Blain, H., Masud, T., Martin, F.C., Maggi, S. (2018). Osteoporosis. In: Roller-Wirnsberger, R., Singler, K., Polidori, M. (eds) Learning Geriatric Medicine. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-319-61997-2_22
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DOI: https://doi.org/10.1007/978-3-319-61997-2_22
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