Elsevier

La Presse Médicale

Volume 35, Issue 10, Part 2, October 2006, Pages 1547-1556
La Presse Médicale

Mise au point
Ostéoporose chez le sujet âgéOsteoporosis in the elderly

https://doi.org/10.1016/S0755-4982(06)74850-3Get rights and content

Points essentiels

L’ostéoporose est une maladie fréquente du sujet âgé, ses conséquences sont catastrophiques en termes de mortalité, de morbidité et de coût.

Les recommandations concernant les procédures diagnostiques sont souvent difficiles à appliquer chez le sujet âgé fragile et polypathologique.

Les bisphosphonates sont le traitement de référence du sujet âgé associés à la supplémentation vitaminocalcique. La correction d’une insuffisance en vitamine D est fondamentale pour prévenir la fracture mais aussi les chutes. Le ranélate de strontium est une alternative prometteuse pour cette population.

La prévention des chutes est indispensable dans la prise en charge de l’ostéoporose du sujet âgé.

Le bénéfice des protecteurs de hanche est actuellement remis en question, même chez les sujets institutionnalisés.

Key points

Osteoporosis is a frequent disease among the elderly and has major consequences in terms of mortality, morbidity and cost.

Guidelines for diagnostic procedures are often difficult to apply in frail, elderly patients with multiple comorbidities.

Bisphosphonates are the reference treatment for the elderly combined with vitamin D and calcium supplementation. Vitamin D deficiency must also be treated to prevent falls and fractures. Strontium ranelate is a promising treatment in this population.

Fall prevention is a major part of osteoporosis management.

The potential benefit of hip protectors is questionable, even in institutionalized patients.

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