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Bone studies “wrong for 70 years”


The majority of bone fractures in elderly people occur in the over-65s, are not vertebral and are caused by a greater loss of cortical and not trabecular bone – contrary to contemporary opinion, according to an article in The Lancet journal.

Therefore drugs which help stop cortical bones decaying may reduce the risk of fracture and should be adopted for age-related bone loss treatment, the article reads.

Research into osteoporosis over the past 70 years has concentrated on trabecular bone loss and vertebrae fractures, despite the fact that around eight in every 10 fractures sustained by elderly people are mainly cortical and non-vertebral.

Researchers in Australia have investigated the ageing effect on the mineral density of bones and cortical porosity using hi-res x-ray computed tomography and electron microscopy.

They argue that current methods used to measure bone mineral density and assess the risk of fracture risk underestimate age-related increases in cortical porosity. Cortical remnants which appear similar to trabeculae are mistakenly viewed and calculated as trabecular bone loss because of trabecularisation of the cortex.

The Lancet article authors said: “Accurate assessment of bone structure, especially porosity-producing cortical remnants, could improve identification of individuals at high and low risk of fracture and therefore assist targeting of treatment.”

Copyright Press Association 2010

The Lancet

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