Southwestern internal medicine conference: Age-related osteoporosis

Osteoporosis is a common disease that results in 1.2 million fractures each year in the United States. The morbidity and mortality as well as the financial impact from this disease is substantial. There has been considerable progress in our understanding of this disorder, but studies commonly include only early postmenopausal individuals. At the same time, it is clear that there are major epidemiologic, physiologic, and clinical differences between early postmenopausal and older individuals. These considerations raise the issue of the appropriateness of generalizing evaluation and treatment recommendations from younger to older patients. This review will focus on the age-related changes in bone physiology as it relates to osteoporosis and consider the available evidence for using commonly used (calcium) or approved (estrogen and calcitonin) agents in the elderly patient.