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Undertreatment of osteoporosis in the oldest old? A nationwide study of over 700,000 older people.

Johnell K, Fastbom J - Arch Osteoporos (2009)

Bottom Line: Raloxifene was also negatively associated with age.Calcium + vitamin D supplements, however, showed a divergent pattern regarding age.Future research is needed for understanding the mechanisms behind this age effect.

View Article: PubMed Central - PubMed

Affiliation: Aging Research Center, Karolinska Institutet, Gävlegatan 16, 113 30 Stockholm, Sweden.

ABSTRACT
SUMMARY: We analysed data from elderly people registered in the Swedish Prescribed Drug Register to investigate whether age is associated with use of osteoporosis drugs in a nationwide population. Our results indicate an undertreatment of osteoporosis, particularly with bisphosphonates, in the oldest old in Sweden. INTRODUCTION: The aim of this study was to investigate whether age is associated with use of osteoporosis drugs in a large population of older people. METHODS: We analysed data on age, sex, type of residential area (urban/rural) and dispensed drugs for people aged >/=75 years registered in the Swedish Prescribed Drug Register from October to December 2005 (n = 731,105). Multivariate logistic regression was used to analyse whether age was associated with use of osteoporosis drugs, after adjustment for type of residential area and number of other drugs (a proxy for comorbidity). RESULTS: Osteoporosis drugs were used by 16.1% of the women and 3.4% of the men. The probability of use of bisphosphonates declined with increasing age [ORwomen = 0.36 (95% CI 0.34-0.38) and ORmen = 0.46 (95% CI 0.37-0.56) for age >/=90 years vs. 75-79 years]. Raloxifene was also negatively associated with age. Calcium + vitamin D supplements, however, showed a divergent pattern regarding age. In women, the lowest likelihood of use of calcium + vitamin D supplements occurred in the oldest old (>/=90 years). CONCLUSIONS: Our results indicate an undertreatment of osteoporosis, particularly with bisphosphonates, in the oldest old in Sweden. Future research is needed for understanding the mechanisms behind this age effect.

No MeSH data available.


Related in: MedlinePlus

Prevalence of calcium + vitamin D supplements according to age (450,482 women and 280,623 men)
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Fig2: Prevalence of calcium + vitamin D supplements according to age (450,482 women and 280,623 men)

Mentions: Mean age among the 731,105 elderly was 82.5 years in women and 81.4 years in men (Table 1). Osteoporosis drugs were used by 16.1% of the women (bisphosphonates, 5.4%; calcium + vitamin D supplements, 14.2% and raloxifene, 0.3%) and 3.4% of the men (bisphosphonates, 0.9% and calcium + vitamin D supplements, 3.1%). The users of bisphosphonates and raloxifene were younger than the non-users of osteoporosis drugs, whereas the male users of calcium + vitamin D supplements were older (Table 1). Figures 1, 2 and 3 show that the prevalence of the three types of osteoporosis drugs was lowest in the oldest old (≥90 years), except for calcium + vitamin D supplements among men. The prevalence of bisphosphonates decreased after 80–84 years, particularly in women (Fig. 1). The use of calcium + vitamin D supplements was most common in the age group 85–89 years (Fig. 2), whereas the prevalence of raloxifene decreased with increasing age throughout the age span (Fig. 3).Table 1


Undertreatment of osteoporosis in the oldest old? A nationwide study of over 700,000 older people.

Johnell K, Fastbom J - Arch Osteoporos (2009)

Prevalence of calcium + vitamin D supplements according to age (450,482 women and 280,623 men)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2836742&req=5

Fig2: Prevalence of calcium + vitamin D supplements according to age (450,482 women and 280,623 men)
Mentions: Mean age among the 731,105 elderly was 82.5 years in women and 81.4 years in men (Table 1). Osteoporosis drugs were used by 16.1% of the women (bisphosphonates, 5.4%; calcium + vitamin D supplements, 14.2% and raloxifene, 0.3%) and 3.4% of the men (bisphosphonates, 0.9% and calcium + vitamin D supplements, 3.1%). The users of bisphosphonates and raloxifene were younger than the non-users of osteoporosis drugs, whereas the male users of calcium + vitamin D supplements were older (Table 1). Figures 1, 2 and 3 show that the prevalence of the three types of osteoporosis drugs was lowest in the oldest old (≥90 years), except for calcium + vitamin D supplements among men. The prevalence of bisphosphonates decreased after 80–84 years, particularly in women (Fig. 1). The use of calcium + vitamin D supplements was most common in the age group 85–89 years (Fig. 2), whereas the prevalence of raloxifene decreased with increasing age throughout the age span (Fig. 3).Table 1

Bottom Line: Raloxifene was also negatively associated with age.Calcium + vitamin D supplements, however, showed a divergent pattern regarding age.Future research is needed for understanding the mechanisms behind this age effect.

View Article: PubMed Central - PubMed

Affiliation: Aging Research Center, Karolinska Institutet, Gävlegatan 16, 113 30 Stockholm, Sweden.

ABSTRACT
SUMMARY: We analysed data from elderly people registered in the Swedish Prescribed Drug Register to investigate whether age is associated with use of osteoporosis drugs in a nationwide population. Our results indicate an undertreatment of osteoporosis, particularly with bisphosphonates, in the oldest old in Sweden. INTRODUCTION: The aim of this study was to investigate whether age is associated with use of osteoporosis drugs in a large population of older people. METHODS: We analysed data on age, sex, type of residential area (urban/rural) and dispensed drugs for people aged >/=75 years registered in the Swedish Prescribed Drug Register from October to December 2005 (n = 731,105). Multivariate logistic regression was used to analyse whether age was associated with use of osteoporosis drugs, after adjustment for type of residential area and number of other drugs (a proxy for comorbidity). RESULTS: Osteoporosis drugs were used by 16.1% of the women and 3.4% of the men. The probability of use of bisphosphonates declined with increasing age [ORwomen = 0.36 (95% CI 0.34-0.38) and ORmen = 0.46 (95% CI 0.37-0.56) for age >/=90 years vs. 75-79 years]. Raloxifene was also negatively associated with age. Calcium + vitamin D supplements, however, showed a divergent pattern regarding age. In women, the lowest likelihood of use of calcium + vitamin D supplements occurred in the oldest old (>/=90 years). CONCLUSIONS: Our results indicate an undertreatment of osteoporosis, particularly with bisphosphonates, in the oldest old in Sweden. Future research is needed for understanding the mechanisms behind this age effect.

No MeSH data available.


Related in: MedlinePlus