Universität zu Köln

Rizzoli, R., Branco, J., Brandi, M-L., Boonen, S., Bruyere, O., Cacoub, P., Cooper, C., Diez-Perez, A., Duder, J., Fielding, R. A., Harvey, N. C., Hiligsmann, M., Kanis, J. A., Petermans, J., Ringe, J. D., Tsouderos, Y., Weinman, J. and Reginster, J-Y. (2014). Management of osteoporosis of the oldest old. Osteoporosis Int., 25 (11). S. 2507 - 2530. LONDON: SPRINGER LONDON LTD. ISSN 1433-2965

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Abstract

This consensus article reviews the diagnosis and treatment of osteoporosis in geriatric populations. Specifically, it reviews the risk assessment and intervention thresholds, the impact of nutritional deficiencies, fall prevention strategies, pharmacological treatments and their safety considerations, the risks of sub-optimal treatment adherence and strategies for its improvement. This consensus article reviews the therapeutic strategies and management options for the treatment of osteoporosis of the oldest old. This vulnerable segment (persons over 80 years of age) stands to gain substantially from effective anti-osteoporosis treatment, but the under-prescription of these treatments is frequent. This report is the result of an ESCEO (European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis) expert working group, which explores some of the reasons for this and presents the arguments to counter these beliefs. The risk assessment of older individuals is briefly reviewed along with the differences between some intervention guidelines. The current evidence on the impact of nutritional deficiencies (i.e. calcium, protein and vitamin D) is presented, as are strategies to prevent falls. One possible reason for the under-prescription of pharmacological treatments for osteoporosis in the oldest old is the perception that anti-fracture efficacy requires long-term treatment. However, a review of the data shows convincing anti-fracture efficacy already by 12 months. The safety profiles of these pharmacological agents are generally satisfactory in this patient segment provided a few precautions are followed. These patients should be considered for particular consultation/follow-up procedures in the effort to convince on the benefits of treatment and to allay fears of adverse drug reactions, since poor adherence is a major problem for the success of a strategy for osteoporosis and limits cost-effectiveness.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rizzoli, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Branco, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brandi, M-L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boonen, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruyere, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cacoub, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cooper, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Diez-Perez, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Duder, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fielding, R. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Harvey, N. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hiligsmann, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kanis, J. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Petermans, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ringe, J. D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tsouderos, Y. UNSPECIFIED UNSPECIFIED UNSPECIFIED Weinman, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reginster, J-Y. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-425312
DOI:	10.1007/s00198-014-2755-9
Journal or Publication Title:	Osteoporosis Int.
Volume:	25
Number:	11
Page Range:	S. 2507 - 2530
Date:	2014
Publisher:	SPRINGER LONDON LTD
Place of Publication:	LONDON
ISSN:	1433-2965
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BONE-MINERAL DENSITY; CLINICAL VERTEBRAL FRACTURES; SERUM 25-HYDROXYVITAMIN D; POSTMENOPAUSAL WOMEN; VITAMIN-D; ZOLEDRONIC ACID; HIP FRACTURE; STRONTIUM RANELATE; VENOUS THROMBOEMBOLISM; NONVERTEBRAL FRACTURES Multiple languages Endocrinology & Metabolism Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/42531