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Osteoporosis in Elderly Patients

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (20 July 2022) | Viewed by 13539

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Prof. Dr. Umberto Tarantino

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Guest Editor

1. Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
2. Department of Orthopaedics and Traumatology, “Policlinico Tor Vergata” Foundation, Viale Oxford 81, 00133 Rome Italy
Interests: osteoporosis; osteoarthritis; fragility fracture; bone biology; bone healing; aging; bone metabolism; age-related bone diseases
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Special Issue Information

Dear Colleagues,

Osteoporosis is a major clinical problem affecting the frail elderly population globally. The fragility fractures caused by this disease have a significant socioeconomic impact, leading to high healthcare costs, reduced quality of life, and increased mortality. The pathogenesis of osteoporosis is multifactorial and associated with several risk factors, including low bone mineral density (BMD), previous fragility fractures, family history of osteoporosis, and particularly age. It is known that at the basis of the state of bone fragility, there is an alteration of the physiological balance of osteoblasts and osteclast activity, resulting in an imbalance toward greater bone resorption. There is also evidence to suggest that the inflammatory process may influence bone turnover, contributing to the deterioration of bone tissue microarchitecture. Given the multifactorial nature of osteoporosis, recent research has also focused on understanding the involvement of environmental, genetic, and epigenetic factors in the pathogenesis of this disease. Current therapeutic options include antiresorptive drugs that reduce bone resorption while preserving bone density, anabolic agents that stimulate new bone formation by increasing BMD, and the administration of parathyroid hormone. In addition, exercise combined with nutritional support of calcium and vitamin D is one of the best strategies to prevent osteoporosis. The aim of this Special Issue on “Osteoporosis in Elderly Patients” will be to direct research toward understanding the mechanisms involved in the pathogenesis of osteoporosis, including all aspects from basic science to the clinic. In addition, as the average age of the world’s population increases, further studies will be needed to define new measures for diagnosis, prevention, and treatment, since the complications associated with this pathology now represent a major public health problem.

Prof. Umberto Tarantino
Guest Editor

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Keywords

Osteoporosis
Fragility fracture
Bone biology
Genetic/epigenetic factors in bone metabolism
Risk factors
Therapeutic treatment
Prevention strategies
Fracture healing
Clinic complications

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Published Papers (5 papers)

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Research

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9 pages, 748 KiB

Open AccessArticle

Age-Specific Normative Values of Lumbar Spine Trabecular Bone Score (TBS) in Taiwanese Men and Women

by Tzyy-Ling Chuang, Mei-Hua Chuang, Yuh-Feng Wang and Malcolm Koo

J. Clin. Med. 2021, 10(20), 4740; https://doi.org/10.3390/jcm10204740 - 15 Oct 2021

Cited by 4 | Viewed by 2044

Abstract

Trabecular bone score (TBS) is a novel method for assessing trabecular microarchitecture. Normative values of TBS are available for various populations of the world but are not yet available for Taiwanese adults. Therefore, the purpose of this study was to estimate age-specific, normative TBS curves for Taiwanese men and women. Medical records of general health examinations from a regional hospital in Southern Taiwan were reviewed. Individuals aged 30–90 years with data on lumbar spine bone mineral density (BMD) were included. TBS was retrospectively calculated from dual-energy X-ray absorptiometry scans using TBS iNsight software. Of the 12,028 patients included, 4533 (37.7%) were male and the mean age was 55.8 years. The mean TBS was 1.392 (standard deviation (SD) 0.089) for men and 1.344 (SD 0.107) for women. In women, TBS declined at a rate of 0.0004/year among those aged 30.0–45.9 years, 0.0106/year among those 46.0–60.7 years, and 0.0028/year among those 60.8–90.0 years. In men, TBS declined at a constant rate of 0.0023/year over the entire age range. In conclusion, age-adjusted, normative curves of TBS for Taiwanese men and women are presented, which could be used to facilitate the use of TBS in assessing bone status in clinical practice. Full article

(This article belongs to the Special Issue Osteoporosis in Elderly Patients)

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15 pages, 4937 KiB

Open AccessArticle

Effect of Dosing Interval on Compliance of Osteoporosis Patients on Bisphosphonate Therapy: Observational Study Using Nationwide Insurance Claims Data

by Hyunil Lee, Sangcheol Lee, Dokyung Kim, Weonmin Cho, Sungtan Cho, Siyeong Yoon and Soonchul Lee

J. Clin. Med. 2021, 10(19), 4350; https://doi.org/10.3390/jcm10194350 - 24 Sep 2021

Cited by 3 | Viewed by 2250

Abstract

Only a few studies are available on the effect of the dosing interval of bisphosphonate on drug compliance. We analyzed the data of patients who were newly prescribed bisphosphonate using a national insurance claims database. Drug compliance was assessed by calculating medication possession ratio (MPR) over a minimum of a 1-year follow-up. This analysis included 281,996 new bisphosphonate users with a mean age of 68.9 years (92% women). The patients were divided into daily, weekly, monthly, 3-monthly, and switch groups (who changed the drug to other dosing intervals). The average MPR was the highest in the switch group (66%), and the longer the dosing interval, the higher the compliance (3-monthly, 56% vs. daily, 37%). “Non-compliant” was defined as an MPR under 80%. Various factors which were possibly associated with “non-compliant” MPR were investigated using multiple regression analysis. Multivariate analysis showed that male patients were more likely to be non-compliant with pharmacotherapy than female patients, with as odds ratio of 1.389. Younger patients had a significantly lower likelihood of being non-compliant than older patients for age 60–69 vs. age 80+. Long dosing intervals were recommended to improve compliance and special attention was given to older and male patients. Full article

(This article belongs to the Special Issue Osteoporosis in Elderly Patients)

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8 pages, 229 KiB

Open AccessArticle

Muscle Mass and Gait Characteristics in Older Women Fallers vs. Non-Fallers

by Yu-Ching Lin, Ing-Jy Tseng, Yi-Chien Lu, Shao-Wei Yang, Chia-Chi Wu, Yen-Nung Lin and Wing P. Chan

J. Clin. Med. 2021, 10(17), 3924; https://doi.org/10.3390/jcm10173924 - 30 Aug 2021

Cited by 2 | Viewed by 1744

Abstract

Background: Falling is a major public health concern of elderly people. We aimed to determine if lean mass and spatiotemporal gait parameters could predict the risk of falling in elderly women and also study the relationships between lean mass and gait characteristics. Methods: Twenty-four community women were prospectively recruited (mean age, 72.30 ± 5.31 years). Lean mass was measured using dual-energy fan-beam X-ray absorptiometry. Gait characteristics were assessed using spatiotemporal analysis. Fall risks were assessed using the Berg Balance Scale (BBS) and the Falls Efficacy Scale-International. Fall histories were recorded. Appropriate statistical analyses were applied to determine lean mass and gait characteristics in predicting the risk of fall and the associations between lean mass and gait characteristics. Results: There were 14 participants (58.33%) with fall histories. Patients with fall histories had a significantly narrower base of support and lower BBS score. However, only the base of support was significantly associated with fall risk (odds ratio, 0.415; p = 0.022). Lean mass was significantly negatively associated with proportion of swing phase and positively associated with proportions of stance and double-support phases. Conclusion: Fall risk among elderly women can be predicted using base of support, where a narrower base predicts a greater fall risk. Although the lean mass was not related to risk of fall, lean mass is still related to some gait characteristics. Full article

(This article belongs to the Special Issue Osteoporosis in Elderly Patients)

11 pages, 447 KiB

Open AccessArticle

Effect of Multimorbidity on Fragility Fractures in Community-Dwelling Older Adults: Shimane CoHRE Study

by Garu A, Shozo Yano, Abdullah Md Sheik, Aorigele Yu, Kenta Okuyama, Miwako Takeda, Kunie Kohno, Masayuki Yamasaki, Minoru Isomura, Toru Nabika and Atsushi Nagai

J. Clin. Med. 2021, 10(15), 3225; https://doi.org/10.3390/jcm10153225 - 22 Jul 2021

Cited by 9 | Viewed by 2091

Abstract

Fragility fractures (FFxs), which are a common musculoskeletal injury in older adults, is associated with an increased frequency of falls. Both FFxs and falls may result from drugs, habits, and co-occurring diseases. We aimed to evaluate the effects of various diseases on the risk of FFx. This retrospective study included 1420 individuals aged ≥60 years. We evaluated the history of clinical FFx and diseases using a detailed questionnaire and a health examination. The risk of comorbidities was assessed using the Age-Adjusted Charlson Comorbidity (AAC) Index. We performed binary logistic regression analysis to determine the risk of FFx and falls after adjusting for covariates. In elderly men, the incidence of FFx positively correlated with rheumatoid arthritis and parent’s hip fracture. For elderly women, the incidence of FFx positively correlated with rheumatoid arthritis and antihypertensive drugs but was inversely associated with dyslipidemia and antilipidemic drugs. The FFX risk of older adults with an AAC Index ≥6 was higher than those with an AAC Index of 1–3. In addition, the AAC Index and falls were independently and strongly associated with a higher risk of FFx. Taken together, multimorbidity increases the risk of clinical FFx independent of falls in the community-dwelling elderly population. Full article

(This article belongs to the Special Issue Osteoporosis in Elderly Patients)

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Review

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11 pages, 1070 KiB

Open AccessReview

T-Score and Handgrip Strength Association for the Diagnosis of Osteosarcopenia: A Systematic Review and Meta-Analysis

by Umberto Tarantino, Chiara Greggi, Virginia Veronica Visconti, Ida Cariati, Mariagrazia Tallarico, Matteo Fauceglia, Riccardo Iundusi, Marco Albanese, Carlo Chiaramonte and Elena Gasbarra

J. Clin. Med. 2021, 10(12), 2597; https://doi.org/10.3390/jcm10122597 - 12 Jun 2021

Cited by 15 | Viewed by 4287

Abstract

Background: Osteosarcopenia is a recently identified condition caused by the coexistence of osteoporosis and sarcopenia that affects the frail elderly population, leading to an increased risk of falls and fractures. Given the recent socio-economic interest associated with osteosarcopenia, the aim of this meta-analysis is to provide an overview of the factors potentially involved in its pathogenesis, assessing its population type, prevalence, and associated variables. Methods: A comprehensive systematic search for relevant studies, published from 2015 to 2020, was performed by using PubMed, EMBASE, and Cochrane databases. We analysed the variables of age, vitamin D, handgrip, and T-score in four different groups: healthy, osteopenic–osteoporotic, sarcopenic, and osteosarcopenic. Results: A total of 6504 patients from 16 studies were included in the final meta-analysis. The analysis of the individual variables reveals a statistically significant correlation between the handgrip test data and T-score (p < 0.001). Conclusions: The correlation between T-score values and handgrip strength suggests a new potential parameter in the development of predictive models that could be used in clinical practice, highlighting its importance for the diagnosis of osteosarcopenia. Full article

(This article belongs to the Special Issue Osteoporosis in Elderly Patients)

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