Treatment Strategies in Osteoporosis

摘要

The burden of osteoporotic fracture is increasing world-wide due to the longevity of the population and in some regions also due to increases in age and sex specific rates of fracture. With a better understanding of causation and treatment of osteoporosis, intervention strategies require development. Global strategies, aimed at the population to decrease fracture risk have not been tested so that greatest attention has been devoted to high risk strategies where segments of the community are identified for treatment. There is a poor case for screening women at the time of the menopause with the assessment of bone mineral density. The rationale for screening in later life is stronger but has not been tested. In the meanwhile, a case-finding approach is advocated where individuals at particualr risk are identified by the presence of clinical risk factors. In such patients treatments can be cost-effectively targeted and cost effectiveness improved still further by patient selection from the assessment of bone mineral density.