How can osteoporosis be treated in elderly women above 70?

Question

Hello doctor,

I am concerned about my mom, who is 72 and just got diagnosed with osteoporosis after her T-score came back at -3.1 in her hip and -2.8 in her spine. She broke her wrist last month from just tripping over the dog, and now we are all scared that she will break something worse. Her vitamin D level was only 18 ng/mL, and calcium was low too, at 8.2 mg/dL. The endocrinologist wants to start her on Alendronate, but she is having terrible acid reflux problems and can not even lie flat at night. She also takes warfarin for her heart condition, so we are worried about interactions. She lost four inches of height in the past two years, and her back pain is getting so bad that she can barely walk to the mailbox. The bone density doctor mentioned some injection options but did not explain them well. What are the safest treatments for someone with her heart problems and stomach issues? She is getting so depressed about becoming frail, and we do not know how to help her.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

Osteoporosis, especially with a T-score of -3.1 in the hip and -2.8 in the spine, can be quite serious.

Given her low vitamin D and calcium levels, it is essential to address these deficiencies first. Supplements can help improve bone health. Alendronate is effective, but it can worsen acid reflux. Injectable options like Denosumab or Teriparatide might be better as they do not affect the stomach and can help increase bone density.

Considering her heart condition and warfarin use, it is crucial to monitor for potential interactions. Consulting with her cardiologist and endocrinologist can help tailor a safe and effective treatment plan. It is important to address her depression and mobility issues, too. Physical therapy and support groups can be beneficial.

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

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.