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Treatment considerations for severe osteoporosis in older adults

Treatment considerations for severe osteoporosis in older adults
Treatment considerations for severe osteoporosis in older adults
Osteoporosis, a chronic metabolic bone disease, increases the predisposition to fragility fractures and is associated with considerable morbidity, high health care cost as well as mortality. An elevation in the rate of incident fragility fractures will be observed proportional with the increase in the number of older people worldwide. Severe osteoporosis is currently defined as having a bone density determined by dual-energy X-ray absorptiometry that is more than 2.5 standard deviations (SD) below the young adult mean with one or more past fractures due to osteoporosis. Nutrition, physical activity and adequate vitamin D are essential for optimal bone strength throughout life. Hormone (oestrogen/sex steroid) status is also a major determinant of bone health. This review explores mechanisms involved in bone homeostasis, followed by the assessment and management of severe osteoporosis, including an overview of several treatment options in older people that range from anti-resorptive to anabolic therapies.
1170-229X
395-412
See, Heidi
36be88aa-7c89-4ae2-a40f-24c71fff9c9b
Gowling, Emma
25a65c8b-48d8-4018-b3ad-459c84fad109
Boswell, Evie
fad43260-bd47-4147-ba6e-fe0b045f4ecb
Aggarwal, Pritti
d13e6516-5b53-4789-b627-115fcebd0d2b
King, Katherine
6ad746d1-93b8-4ea0-bc20-bd8f9fe7fd8f
Smith, Nicola
923b9202-b626-4422-bd2f-529db992e98b
Lim, Stephen
dd2bfbd7-7f74-4365-b77e-9989f6408ddc
Baxter, Mark
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Patel, Harnish P.
e1c0826f-d14e-49f3-8049-5b945d185523
See, Heidi
36be88aa-7c89-4ae2-a40f-24c71fff9c9b
Gowling, Emma
25a65c8b-48d8-4018-b3ad-459c84fad109
Boswell, Evie
fad43260-bd47-4147-ba6e-fe0b045f4ecb
Aggarwal, Pritti
d13e6516-5b53-4789-b627-115fcebd0d2b
King, Katherine
6ad746d1-93b8-4ea0-bc20-bd8f9fe7fd8f
Smith, Nicola
923b9202-b626-4422-bd2f-529db992e98b
Lim, Stephen
dd2bfbd7-7f74-4365-b77e-9989f6408ddc
Baxter, Mark
3415aa9a-8eb0-454e-9b7a-dadb1ce4e5c6
Patel, Harnish P.
e1c0826f-d14e-49f3-8049-5b945d185523

See, Heidi, Gowling, Emma, Boswell, Evie, Aggarwal, Pritti, King, Katherine, Smith, Nicola, Lim, Stephen, Baxter, Mark and Patel, Harnish P. (2025) Treatment considerations for severe osteoporosis in older adults. Drugs & Aging, 42 (5), 395-412, [100097]. (doi:10.1007/s40266-025-01205-5).

Record type: Article

Abstract

Osteoporosis, a chronic metabolic bone disease, increases the predisposition to fragility fractures and is associated with considerable morbidity, high health care cost as well as mortality. An elevation in the rate of incident fragility fractures will be observed proportional with the increase in the number of older people worldwide. Severe osteoporosis is currently defined as having a bone density determined by dual-energy X-ray absorptiometry that is more than 2.5 standard deviations (SD) below the young adult mean with one or more past fractures due to osteoporosis. Nutrition, physical activity and adequate vitamin D are essential for optimal bone strength throughout life. Hormone (oestrogen/sex steroid) status is also a major determinant of bone health. This review explores mechanisms involved in bone homeostasis, followed by the assessment and management of severe osteoporosis, including an overview of several treatment options in older people that range from anti-resorptive to anabolic therapies.

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CLEAN March 2025 Treatment Severe Osteoporosis HPP - Accepted Manuscript
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Accepted/In Press date: 26 March 2025
Published date: 16 April 2025
Additional Information: For the purpose of Open Access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission.

Identifiers

Local EPrints ID: 501421
URI: http://eprints.soton.ac.uk/id/eprint/501421
ISSN: 1170-229X
PURE UUID: 91ace506-5c9c-4f23-a282-bc38582cb306
ORCID for Stephen Lim: ORCID iD orcid.org/0000-0003-2496-2362
ORCID for Harnish P. Patel: ORCID iD orcid.org/0000-0002-0081-1802

Catalogue record

Date deposited: 30 May 2025 16:56
Last modified: 03 Sep 2025 01:47

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Contributors

Author: Heidi See
Author: Emma Gowling
Author: Evie Boswell
Author: Pritti Aggarwal
Author: Katherine King
Author: Nicola Smith
Author: Stephen Lim ORCID iD
Author: Mark Baxter
Author: Harnish P. Patel ORCID iD

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