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How should senile osteoporosis be treated?

Osteoporosis is characterized by progressive loss of bone, destruction of bone microstructure, decrease of bone strength and increase of brittleness. It is characterized by compression and collapse of spine, short stature and kyphosis of spine, which increase the possibility of fracture and decrease of self-care ability. It is a chronic disease that seriously affects the quality of life of the elderly. The process is slow and hard to detect. It is known as the silent thief that damages health silent thief。

1、 Factors causing osteoporosis

Osteoporosis means that the rate of bone resorption increases and exceeds bone formation, or although bone resorption is normal and bone formation decreases, its etiology is not clear. Although most cases can be explained by estrogen deficiency, no one reason has been confirmed as an inevitable factor. In fact, osteoporosis is the result of many factors in the process of life. These factors that affect the progression of disease are called 'risk factors':

*Family history of osteoporosis or multiple fractures

*Long term use of glucocorticoids (cortisone or prednisone, etc.)

*Primary hyperparathyroidism

*Early amenorrhea (surgical or physiological)

*Decreased sex hormone levels (decreased estrogen levels in women, decreased androgen levels in men)

Other influencing factors included less activity, insufficient intake of calcium, vitamin D and vitamin K in diet, drinking, smoking, long-term consumption of caffeinated beverages (coffee, tea or cola, etc.), history of gastrectomy, long-term use of certain drugs such as aluminum containing antacids, anticonvulsants, heparin and methotrexate, etc. In addition to genetic and other physiological factors, living habits play an important role in these risk factors. The investigation in Shanghai also shows that the incidence of bone symptoms in those who have adequate intake of meat and milk is lower than that in those who have mainly vegetarian diet. Although there is not enough scientific data to confirm that the above factors can predict osteoporosis, if there are multiple factors at the same time, the probability of osteoporosis will increase. However, the diagnosis of osteoporosis can only be confirmed by in vivo bone mass measurement. Understanding these risk factors will help us to prevent and treat osteoporosis.

Clinically, osteoporosis can be divided into primary and secondary, primary osteoporosis such as idiopathic, postmenopausal, senile osteoporosis; secondary osteoporosis such as endocrine disorders and other diseases caused by iatrogenic drug treatment.

2、 Treatment of osteoporosis

There are various causes of osteoporosis, so the prevention and treatment programs are not the same. For the lack of dietary calcium intake, calcium supplement is the main method, supplemented with vitamin D when necessary; for the osteoporosis caused by the decrease of sex hormone level, sex hormone supplement is the main method. Studies have proved that estrogen replacement therapy can reduce the incidence of fracture in postmenopausal women; In recent years, great progress has been made in the research of drugs to improve bone metabolism, inhibit bone resorption and promote bone formation.

According to the characteristics of osteoporotic drugs, they can not be divided into three categories: calcium metabolism promoting drugs and bone metabolism promoting drugs.