Understanding the Mechanisms of Senile Osteoporosis: New Facts for a Major Geriatric Syndrome

Knowledge of the underlying mechanisms of osteoporosis in older adults has significantly advanced in recent years. There is an acute loss of bone mineral density in the peri‐menopausal period, followed by a more gradual and progressive decline, which is also seen in men. Markedly increased bone reso...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) 2008-05, Vol.56 (5), p.935-941
Main Authors: Duque, Gustavo, Troen, Bruce R.
Format: Article
Language:English
Subjects:
Adipocytes - physiology
adipogenesis
Age differences
Age Factors
Aged
Aged, 80 and over
Biological and medical sciences
Bone density
Bone Density - physiology
bone formation and resorption
Bone Marrow - physiopathology
Bone Remodeling - physiology
Bone Resorption - physiopathology
Cathepsin K
Cathepsins - metabolism
Diseases of the osteoarticular system
Female
General aspects
Geriatrics
Humans
Hydrogen-Ion Concentration
Male
Medical sciences
Miscellaneous
Older people
osteoblast
Osteoblasts - physiology
osteoclast
Osteoclasts - physiology
Osteoporosis
Osteoporosis - physiopathology
Osteoporosis - therapy
Osteoporosis, Postmenopausal - physiopathology
Osteoporosis, Postmenopausal - therapy
Osteoporosis. Osteomalacia. Paget disease
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk Factors
Sex Factors
Vitamin D Deficiency - physiopathology
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Summary:Knowledge of the underlying mechanisms of osteoporosis in older adults has significantly advanced in recent years. There is an acute loss of bone mineral density in the peri‐menopausal period, followed by a more gradual and progressive decline, which is also seen in men. Markedly increased bone resorption leads to the initial fall in bone mineral density. With increasing age, there is also a significant reduction in bone formation. This is mostly due to a shift from osteoblastogenesis to predominant adipogenesis in the bone marrow. This study reviews new evidence on the pathophysiology of senile osteoporosis, with emphasis upon the mechanism of action of current osteoporosis treatments. New potential treatments are also considered, including therapeutic approaches to osteoporosis in elderly people that focus on the pathophysiology and potential reversal of the adipogenic shift in bone.
ISSN:0002-8614
1532-5415
DOI:10.1111/j.1532-5415.2008.01764.x