Oateoporosis – diagnostic and treatment in elderly patients
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 5
Abstract
Fractures are a clinical issue in osteoporosis, thus the aim of the diagnostic process is to identify properly patients who are at risk of fractures. In current medical practice the most importants issue in making therapeutic decisions is to conduct fracture risk assessment for an individual patient. In order to calculate a 10-year absolute fracture risk one can use FRAX (WHO fracture risk assessment) wchich is a questionnaire proposed by WHO. The fracture risk for an individual person can be calculated based on population risk, BMD, and independent risk factors such as: low BMI < 20 kg/m2, parental history of proximal femur fracture, prior low energy fractures after the age of 50, smoking, glicocortycosteroids treatment, rheumatoid arthritis, overuse of alcohol.Although the old age of a patient increases the probablility of a BMD value meeting the densytometric criteria for primary osteoporosis, it does not exclude presence of secondary osteoporosis. That is why one should conduct a differential diagnosis using appropriate laboratory tests before the beginning of osteoporosis treatment. Fast increases in the population of the elderly create the need for actions whose priority is to lower the risk for osteoporotic fractures. Such actions should include lowering influences of risk factors, preventing falls, improving bone resistance with the use of famacology especially antiresorptic and anabolic drugs. In the elderly, the treatment should include, apart from prescribing appropriate medications, taking into consideration contraindications and way of supplying, also attepting to motivate the patient to follow the guidelines for treatment of chronic diseases.
Authors and Affiliations
Ewa Marcinowska-Suchowierska, Edward Czerwiński, Janusz Badurski, Magdalena Walicka, Marek Tałałaj
Keywords
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