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British Medical Bulletin 46:94-112 (1990)
© 1990 The British Council

research-article

Osteoporosis

W J MacLennan

Department of Geriatric Medicine, University of Edinburgh Edinburgh, UK

Abstract

The development of accurate methods for measuring bone density has made it possible to evaluate more effectively methods for the prevention and treatment of osteoporosis. Calcium supplements are not required in early life for people with a normal dietary intake of the substance, but may reduce the risk of fractures in postmenopausal women. The role of oestrogens in the reduction of postmenopausal bone loss is well established. Vitamin D and its metabolites are of doubtful efficacy in this situation and carry the risk of side effects associated with hypercalcaemia. Treatment with sodium fluoride increases bone density, but its effect on the incidence of fractures remains uncertain. Bone rarefaction can be reduced with calcitonin but administration remains a problem. Elderly patients can be effectively treated with anabolic steroids with relatively small risk of long term side effects. Coherence therapy is a promising new approach which has yet to be fully evaluated. There is no doubt that physical exercise reduces bone loss and increases skeletal density.


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