How can the elderly prevent fractures from osteoporosis?

Question

Hello doctor,

My 67-year-old mother was diagnosed with osteoporosis after a DEXA scan showed a T-score of -3.2 at the spine and -2.8 at the hip. She fell last month and fractured her wrist, which led to the diagnosis. Her calcium levels are normal (9.5), but her vitamin D level is low at 18. She has been taking Alendronate 70 mg weekly for the past two months, but complains of stomach upset. She also has GERD, which worsens the symptoms. The endocrinologist mentioned starting Teriparatide injections, but insurance approval has been difficult. My mother is afraid of more fractures because she lives alone and her balance has worsened. She has stopped doing her walking exercises due to the fear of falling again. Can you suggest alternative treatments for osteoporosis and ways to prevent further fractures?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

I am sorry to hear about your mother's condition. Osteoporosis can be challenging, but there are several treatment options and preventive measures available.

Since Alendronate causes stomach upset, other medications like Risedronate or Ibandronate, which are also Bisphosphonates, might be better tolerated. Denosumab, a monoclonal antibody, is another option that is administered via injection every six months and may be easier on the stomach. Teriparatide, as mentioned, is a good option but can be expensive and may require insurance approval.

To prevent further fractures, it is important to ensure adequate calcium and vitamin D intake. Your mother should continue taking vitamin D supplements to improve her levels. Weight-bearing exercises, such as walking, are beneficial, but she should do them in a safe environment to minimize the risk of falls. Balance training and physical therapy can also help improve stability. Additionally, making her home safer by removing tripping hazards and using assistive devices can reduce the risk of falls.

Please book a consultation with me if you would like more detailed information on any of these points or if you have other questions.

Take care.

Regards.