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Senile osteoporosis has been recently recognized as a geriatric syndrome with a particular pathophysiology. There are different classification of osteoporosis: primary, in which bone loss is a result of aging and secondary, in which bone loss occurs from various clinical and lifestyle factors. [1]
Evidence suggests that exercise can help promote bone health in older people. [139] In particular, physical exercise can be beneficial for bone density in postmenopausal women, [140] and lead to a slightly reduced risk of a bone fracture (absolute difference 4%). [141]
Osteopenia, known as "low bone mass" or "low bone density", is a condition in which bone mineral density is low. [1] Because their bones are weaker, people with osteopenia may have a higher risk of fractures, and some people may go on to develop osteoporosis. [2] In 2010, 43 million older adults in the US had osteopenia. [3]
Bone density declines with age. By the age of 85 years, ~70% of women and 30% of men have a osteoporosis defined as a bone density less than or equal to 2.5 standard deviations lower than young adults. [39]
A scanner used to measure bone density using dual energy X-ray absorptiometry. Bone density, or bone mineral density, is the amount of bone mineral in bone tissue.The concept is of mass of mineral per volume of bone (relating to density in the physics sense), although clinically it is measured by proxy according to optical density per square centimetre of bone surface upon imaging. [1]
X-ray of the hips in osteogenesis imperfecta, showing low bone density. The main symptom of osteogenesis imperfecta is fragile, low mineral density bones; all types of OI have some bone involvement. [5] In moderate and especially severe OI, the long bones may be bowed, sometimes extremely so. [28]
Bone densities are often given to patients as a T score or a Z score. A T score tells the patient what their bone mineral density is in comparison to a young adult of the same gender with peak bone mineral density. A normal T score is -1.0 and above, low bone density is between -1.0 and -2.5, and osteoporosis is -2.5 and lower.
Frail elderly patients (score of 4 or 5) have even worse outcomes, with the risk of being discharged to a nursing home rising to twenty times the rate for non-frail elderly people. Another tool that has been used to predict frailty outcome post-surgery is the Modifies Frailty Index, or mFI-5. This scale consists of 5 key co-morbidities: [62]