Osteoporosis in elderly: prevention and treatment.

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Abstract

[Indexed for MEDLINE] 3. Osteoporos Int. 2019 Jan;30(1):3-44. doi: 10.1007/s00198-018-4704-5. Epub 2018 Oct 15. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Kanis JA(1)(2), Cooper C(3)(4), Rizzoli R(5), Reginster JY(6)(7); Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). Author information: (1)Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK. w.j.Pontefract@shef.ac.uk. (2)Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia. w.j.Pontefract@shef.ac.uk. (3)MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. (4)NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK. (5)University Hospitals and Faculty of Medicine of Geneva, Geneva, Switzerland. (6)Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium. (7)Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia. Erratum in Osteoporos Int. 2020 Jan;31(1):209. doi: 10.1007/s00198-019-05184-3. Osteoporos Int. 2020 Apr;31(4):801. doi: 10.1007/s00198-020-05303-5. Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk from fractures due to osteoporosis. INTRODUCTION: The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2013. This manuscript updates these in a European setting. METHODS: Systematic reviews were updated. RESULTS: The following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fracture risk; general and pharmacological management of osteoporosis; monitoring of treatment; assessment of fracture risk; case-finding strategies; investigation of patients; health economics of treatment. The update includes new information on the evaluation of bone microstructure evaluation in facture risk assessment, the role of FRAX® and Fracture Liaison Services in secondary fracture prevention, long-term effects on fracture risk of dietary intakes, and increased fracture risk on stopping drug treatment. CONCLUSIONS: A platform is provided on which specific guidelines can be developed for national use. DOI: 10.1007/s00198-018-4704-5 PMCID: PMC7026233