Osteoporosis in the older woman: a reappraisal.

Osteoporosis is most acutely experienced by the elderly, yet little research has focused on this problem in this group. Recommendations for osteoporosis prevention and treatment in the elderly have been extrapolated from studies of perimenopausal women. However, there are substantial differences between perimenopausal and elderly women in factors related to bone metabolism, rate of bone loss, architecture of remaining bone, the types of fractures sustained, and risk factors for fracture. Finally, unlike the perimenopausal women, the majority of older women already have osteopenia, or bone loss. Each of these factors is reviewed, and its implications for treatment and future research are explored.