Summary: It is estimated that about 2 million people in Poland suffer from osteoporosis. Unfortunately, about 70 percent of them are not diagnosed, and of the correctly diagnosed patients only a few receive full, multi-profile treatment aimed at preventing the most serious complications. The aim of this study is to systematize information on the prevention and treatment of this disease.
Considering the complex etiology, a holistic approach to the prevention of osteoporosis seems necessary, beginning with education and lifestyle modifications aimed at reducing risk factors, in addition to effective treatment of diseases causing secondary osteoporosis, and finally dietary measures including, when necessary, vitamin D and calcium supplementation. Correct diagnosis is also an important issue. Qualification for pharmacotherapy of osteoporosis is based on the occurrence of low-energy fractures, assessment of 10-year probability of fracture with the FRAX calculator and the determination of reduced bone mineral density in DXA.
In pharmacological treatment, depending on the clinical situation and the patient's preferences, possible ways of treatment consist of orally or intravenously administered bisphosphonates, denosumab, teriparatide or raloxifene. A necessary condition for the administration of each of these is the correct concentration of calcium and vitamin D in the serum.
In addition to pharmacotherapy, extremely important options, especially in the elderly with diagnosed osteoporosis, include multi-profile interventions aimed at reducing the risk of low-energy fractures, such as evaluation of the occurrence of sarcopenia, frailty, malnutrition, orthostatic hypotension, corrective glasses or hearing aids prescription in cases of sensory deprivation and, finally, advice concerning useful changes in the architecture of the patient’s apartment.