Osteoporosis International vol:21 Suppl 2 pages:415-423
Osteoporotic fractures are associated with significant morbidity and mortality with an enormous impact on society and the lives of affected individuals. Age and menopause are the two main risk factors for osteoporosis, and women therefore need to be particularly concerned about bone loss at this time. In addition to suffering fracture-associated morbidity, women with prior fractures have an increased risk of future fractures. Young postmenopausal women who have experienced a fragility fracture therefore face a lifetime of fracture risk. The burden of fractures increases with advancing age, and bone mineral density declines, with women over the age of 80 years having the highest risk of fracture because of their high prevalence of osteoporosis and an increased likelihood of falls. A number of antiosteoporotic agents are available for the treatment of postmenopausal women including bisphosphonates, raloxifene, teriparatide, and strontium ranelate. For osteoporotic drugs to be beneficial in reducing the burden of fractures, they need to be effective against fracture in all age groups of postmenopausal women. With its dual mode of action, strontium ranelate is the first agent with proven early and sustained antifracture efficacy in all age groups including young postmenopausal women and those over 80 years. Evidence is now available to show that all women, including the elderly, can benefit from treatment to prevent further bone loss and restore lost bone to decrease the risk of further fractures. By implementing procedures to identify those at greatest risk and initiate safe and effective treatments, physicians can significantly improve patients' quality of life.