Reflection on “Falling” : How to Prevent and Treat Senile Osteoporosis Correctly

The elderly osteoporosis and an accidental hip fracture have become the cause of academician yuanlongping leaving us. At the same time, it is necessary for the elderly friends to be vigilant and pay more attention to osteoporosis and hip fracture. As a joint surgeon, Dr Xiao also needs to reflect on and think about the osteoporosis treatment scheme commonly used by the common people.
The core of prevention and treatment of osteoporosis in the elderly
The core principle of osteoporosis in the elderly is the abnormal metabolism of calcium, including the decrease of calcium absorption in gastrointestinal tract and the calcium deposition barrier to bone. Both of these problems are due to the reduction of 1,25 hydroxyvitamin D3 synthesized by the kidney, commonly known as “active vitamin D3”. Due to the lack of active vitamin D3, the ability of intestinal epithelial cells to absorb and transport calcium decreased, while the calcium deposition efficiency to bone decreased.
Therefore, the prevention and treatment of osteoporosis in the elderly should be based on supplement of active vitamin D3 and correction of abnormal calcium metabolism.
However, some doctors tend to supplement calcium and stress the importance of imbalance in osteoporosis.
? Thinking about the first choice of drugs for osteoporosis treatment
Bone need to be updated every day. Osteoclasts remove the aging and degenerative bone, and at the same time, osteoblasts synthesize new bone in situ. The osteoporotic in the elderly often has the problems of hyperfunction of osteoclasts and the lack of osteoblast activity. One of the solutions is to take bisphosphate preparation orally, which can correct the negative balance of bone transformation by inhibiting the function of osteoclasts, and achieve the purpose of improving bone mass. Therefore, the combination of calcium plus diphosphate is often the first drug combination for their treatment of osteoporosis.
It is worth noting that relying on calcium supplement alone can not solve the problems of the decrease of calcium absorption efficiency and the deposition of calcium to bone in the intestine; The increase of bone mass by inhibiting bone transformation can not solve the problem of bone deterioration due to the insufficient conversion rate and the increase of brittleness. Moreover, once the long-term bisphosphate is stopped, it is easy to reduce the bone mass by paracetamol, which must be paid attention to.
Therefore, Dr Xiao would like to take this opportunity to call for the treatment of osteoporosis to return to the root, and more emphasis on the importance of daily supplement of sufficient calcium and active osteotriphorol. Other drugs, including diphosphate, are used as adjuvant or alternative.

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