Age-related changes in calcium metabolism. Why they occur and what can be done.

Aging has myriad effects on calcium homeostasis and metabolism. Levels of parathyroid hormone rise, making the diagnosis of primary hyperparathyroidism more difficult. Vitamin D levels decline, affecting the rate of calcium absorption from the intestine. As more and more physicians attempt to combat osteoporosis with calcium supplements, an increasing number of cases of hyperparathyroidism will likely be diagnosed. The use of supplemental calcium is probably appropriate for most elderly patients, particularly white women, but experimental evidence supporting this recommendation is surprisingly scanty. The patient's age is a major consideration when assessing laboratory results, disease risk, and optimal therapeutic strategies.