Osteoporosis in the elderly
https://doi.org/10.14341/osteo12352
Abstract
Osteoporosis in the elderly and senile can be compared with the epidemic of the 21st century due to the high prevalence and increased incidence among people who have survived the 50-year threshold, which make up the bulk of patients. Osteoporosis is associated with a significant increase in the risk of falls and fractures, leading to adynamia and an increased risk of death. Despite the insufficient knowledge of the pathogenesis of the disease, the available data have already allowed the development of preventive measures and treatment principles. Currently, there are preventive and therapeutic measures aimed at reducing the risk of falls, fractures and repeated fractures, however, earlier detection of the disease in old age is often difficult due to the characteristic features of geriatric patients. The polymorbidity, unexpressed clinical picture, the development of frailty syndrome, sarcopenia, social and mental maladaptation and an increase in the frequency of depression make the population of elderly and senile people vulnerable to an increased risk of osteoporosis, falls and fractures and associated hospitalizations and mortality. This review highlights the features of pathogenesis, clinical features, principles of treatment and prevention of osteoporosis in the older age group.
About the Authors
Ekaterina N. DudinskayaRussian Federation
MD, PhD
Natalia V. Brailova
Russian Federation
MD, PhD
Veronika A. Kuznetsova
Russian Federation
Student
Olga N. Tkacheva
Russian Federation
MD, PhD, professor
References
1. Dent E, Morley JE, Cruz-Jentoft AJ, et al. Physical Frailty: ICFSR International Clinical Practice Guidelines for Identification and Management. J. Nutr. Health Aging. 2019;23(9):771-787. doi: https/doi.org/10.1007/s12603-019-1273-z.
2. Ткачева О.Н., Рунихина Н.К., Котовская Ю.В., и др. Ведение пациентов со старческой астенией в первичном звене здравоохранения. Учебное пособие для врачей – М.: Изд-во РАМН, 2016. [Tkacheva ON, Runikhina NK, Kotovskaya YuV, et al. Vedenie pacientov so starcheskoi asteniei v pervichnom zvene zdravooxranenia. Uchebnoe posobie dlya vrachei. Moscow: Izd-vo RAMN; 2016. (In Russ).].
3. Gielen E, Bergmann P, Bruyère O, et al. Osteoporosis in Frail Patients: A Consensus Paper of the Belgian Bone Club. Calcif. Tissue Int. 2017;101(2):111-131. doi: https/doi.org/10.1007/s00223-017-0266-3.
4. Клинические рекомендации по профилактике и ведению больных с остеопорозом. Издание 2-ое, дополненное. / Под ред. Лесняк О.М. — Ярославль: ИПК «Литера», 2013. [Lesnyak OM, editor. Klinicheskie rekomendacii po profilaktike i vedeniju bol’nyh s osteoporozom. Izdanie 2-oe, dopolnennoe. Yaroslavl’: IPK «Litera»; 2013 (In Russ).].
5. de Liefde II, van der Klift M, de Laet CEDH, et al. Bone mineral density and fracture risk in type-2 diabetes mellitus: the Rotterdam Study. Osteoporos. Int. 2005;16(12):1713-1720. doi: https/doi.org/10.1007/s00198-005-1909-1.
6. Пигарова Е.А., Рожинская Л.Я., Белая Ж.Е., и др. Клинические рекомендации Российской ассоциации эндокринологов по диагностике, лечению и профилактике дефицита витамина D у взрослых // Проблемы Эндокринологии. - 2016. - Т. 62. - №4. - C. 60-84. [Pigarova EA, Rozhinskaya LY, Belaya JE, et al. Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults. Problems of Endocrinology. 2016;62(4):60-84. (In Russ).] doi: https/doi.org/10.14341/probl201662460-84.
7. Lau AN, Adachi JD. Bone Aging. In: Nakasato Y, Yung R, editors. Geriatric Rheumatology. New York: Springer, NY; 2011, p.11-17. Doi: https://doi.org/10.1007/978-1-4419-5792-4.
8. Мельниченко Г.А., Белая Ж.Е., Рожинская Л.Я., и др. Краткое изложение клинических рекомендаций по диагностике и лечению остеопороза // Остеопороз и остеопатии. — 2016. — Т. 19. — №3. — С. 28-36. [Melnichenko GA, Belaya ZE, Rozhinskaya LY, et al. Summary of Clinical Guidelines for the Diagnosis and Treatment of Osteoporosis of the Russian Association of Endocrinologists. Osteoporosis and Bone Diseases. 2016;19(3):28-36. (In Russ).]. doi: https/doi.org/10.14341/osteo2016328-36.
9. Karlsson MK, Magnusson H, von Schewelov T, Rosengren BE. Prevention of falls in the elderly—a review. Osteoporos. Int. 2013;24(3):747-762. doi: https/doi.org/10.1007/s00198-012-2256-7.
10. Рожинская Л.Я. Диагностика и лечение остеопороза // Клиническая геронтология. — 2007. — Т. 13. – №2. — С. 37-46. [Rozhinskaja LYa. Diagnostika i lechenie osteoporoza // Klinicheskaja gerontologija. 2007;13(2):37-46 (In Russ).].
11. Qi H, Sheng Y, Chen S, et al. Bone mineral density and trabecular bone score in Chinese subjects with sarcopenia. Aging Clin. Exp. Res. 2019;31(11):1549-1556. doi: https/doi.org/10.1007/s40520-019-01266-8.
12. Johansson H, Siggeirsdóttir K, Harvey NC, et al. Imminent risk of fracture after fracture. Osteoporos. Int. 2016;28(3):775-780. doi: https/doi.org/10.1007/s00198-016-3868-0.
13. Мазуров В.И., Лесняк О.М., Белова К.Ю., и др. Алгоритмы выбора терапии остеопороза при оказании первичной медико-санитарной помощи и организации льготного лекарственного обеспечения отдельных категорий граждан, имеющих право на получение государственной социальной помощи. Системный обзор и резолюция Экспертного совета Российской ассоциации по остеопорозу // Профилактическая медицина. — 2019. — №1. — С. 57-65. [Mazurov VI, Lesnyak OM, Belova KY, et al. Algorithm for selection of drug for osteoporosis treatment in primary care and in organization of provision with medicinal products of citizens eligible for state social assistance. Review of the literature and position of Russian Association on Osteoporosis Expert Council. Profilakticheskaya meditsina. 2019;22(1):57. (In Russ.)] doi: https/doi.org/10.17116/profmed20192201157.
14. Boonen S, Marin F, Mellstrom D, et al. Safety and Efficacy of Teriparatide in Elderly Women with Established Osteoporosis: Bone Anabolic Therapy from a Geriatric Perspective. J. Am. Geriatr. Soc. 2006;54(5):782-789. doi: https/doi.org/10.1111/j.1532-5415.2006.00695.x.
15. Cosman F, Hattersley G, Hu M-y, et al. Effects of Abaloparatide-SC on Fractures and Bone Mineral Density in Subgroups of Postmenopausal Women With Osteoporosis and Varying Baseline Risk Factors. J. Bone Miner. Res. 2017;32(1):17-23. doi: https/doi.org/10.1002/jbmr.2991.
16. Fahrleitner-Pammer A, Langdahl BL, Marin F, et al. Fracture rate and back pain during and after discontinuation of teriparatide: 36-month data from the European Forsteo Observational Study (EFOS). Osteoporos. Int. 2010;22(10):2709-2719. doi: https/doi.org/10.1007/s00198-010-1498-5.
Supplementary files
Review
For citations:
Dudinskaya E.N., Brailova N.V., Kuznetsova V.A., Tkacheva O.N. Osteoporosis in the elderly. Osteoporosis and Bone Diseases. 2019;22(3):34-40. (In Russ.) https://doi.org/10.14341/osteo12352

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