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Vitamin D can quickly deal with Osteoporosis in the very old – Europe working group review – July 2014

Management of osteoporosis of the oldest old.

Osteoporos Int. 2014 Jul 15. [Epub ahead of print]
Rizzoli R1, Branco J, Brandi ML, Boonen S, Bruyère O, Cacoub P, Cooper C, Diez-Perez A, Duder J, Fielding RA, Harvey NC, Hiligsmann M, Kanis JA, Petermans J, Ringe JD, Tsouderos Y, Weinman J, Reginster JY.
1Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland, Rene.Rizzoli at unige.ch.


This consensus article reviews the diagnosis and treatment of osteoporosis in geriatric populations. Specifically, it reviews the risk assessment and intervention thresholds, the impact of nutritional deficiencies, fall prevention strategies, pharmacological treatments and their safety considerations, the risks of sub-optimal treatment adherence and strategies for its improvement.

INTRODUCTION:
This consensus article reviews the therapeutic strategies and management options for the treatment of osteoporosis of the oldest old. This vulnerable segment (persons over 80 years of age) stands to gain substantially from effective anti-osteoporosis treatment, but the under-prescription of these treatments is frequent.

METHODS:
This report is the result of an ESCEO (European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis) expert working group, which explores some of the reasons for this and presents the arguments to counter these beliefs. The risk assessment of older individuals is briefly reviewed along with the differences between some intervention guidelines. The current evidence on the impact of nutritional deficiencies (i.e. calcium, protein and vitamin D) is presented, as are strategies to prevent falls. One possible reason for the under-prescription of pharmacological treatments for osteoporosis in the oldest old is the perception that anti-fracture efficacy requires long-term treatment. However, a review of the data shows convincing anti-fracture efficacy already by 12 months.

RESULTS:
The safety profiles of these pharmacological agents are generally satisfactory in this patient segment provided a few precautions are followed.

CONCLUSION:
These patients should be considered for particular consultation/follow-up procedures in the effort to convince on the benefits of treatment and to allay fears of adverse drug reactions, since poor adherence is a major problem for the success of a strategy for osteoporosis and limits cost-effectiveness.

PMID: 25023900


Publisher charges $28 for the study
Introduction
Ageing and age-related changes to the body
Osteoporosis in older individuals
Therapeutic approaches to osteoporosis: nutritional supplementation and vitamin D
Strategies to prevent falls in older individuals
Therapeutic approaches to osteoporosis: pharmacological strategies
The onset of anti-fracture efficacy
Safety of anti-osteoporotic drugs
Pain management
Optimising therapeutic adherence in osteoporosis
Conclusions on goals and challenges of osteoporosis treatment in the oldest old

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I agree: Henry Lahore July 2014

I play duplicate bridge each week with about 25 other senior citizens
Last month one of the players had fallen and broken her pelvis, so did not show up to play
I told the other players that just a little vitamin D would decrease their chance of similar broken bones by 3X
While statistically about 5 of the players will get broken bones during the next decade,
not ONE of them asked for any information about vitamin D.
They appeared to believe that they cannot change their destiny - as was indicated in this study

See also VitaminDWiki

  • FACT: Bones need Calcium (this has been known for a very long time)
  • FACT: Vitamin D improves Calcium bioavailability (3X ?)
  • FACT: Should not take > 750 mg of Calcium if taking lots of vitamin D (Calcium becomes too bio-available)
  • FACT: Adding vitamin D via Sun, UV, or supplements increased vitamin D in the blood
  • FACT: Vitamin D supplements are very low cost
  • FACT: Many trials, studies. reviews, and meta-analysis agree: adding vitamin D reduces osteoporosis
  • FACT: Toxic level of vitamin D is about 4X higher than the amount needed to reduce osteoporosis
  • FACT: Co-factors help build bones.
  • FACT: Vitamin D Receptor can restrict Vitamin D from getting to many tissues, such as bones
  • It appears that to TREAT Osteoporosis:
  •        Calcium OR vitamin D is ok
  •        Calcium + vitamin D is good
  •        Calcium + vitamin D + other co-factors is great
  •        Low-cost Vitamin D Receptor activators sometimes may be helpful
  • CONCLUSION: To PREVENT many diseases, including Osteoporosis, as well as TREAT Osteoporosis
  • Category Osteoporosis has 187 items
  • Category Bone Health has 265 items

Note: Osteoporosis causes bones to become fragile and prone to fracture
  Osteoarthritis is a disease where damage occurs to the joints at the end of the bones

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