Osteoporosis Update 2010 Nova Science Publishers, Inc., 2010;

PROBLEMS IN THE PREVENTION OF OSTEOPOROSIS AND THE ASSESSMENT OF BONE DENSITY

Year: 2010

P. Schneider
University of Würzburg, Würzburg, Germany.

Abstract

The recommendations of the WHO suggested intervention thresholds for assessment
of fracture risks and consecutive treatment in postmenopausal women. Large continuous
efforts are undertaken to adjust for problems of misclassification according to these
statistical thresholds in using bone densitometry. These problems arise mainly from a
wrong paradigm on bone’s disease. Current concept uses bone densitometers to compare densities of individuals with samples of a “normal” population. According to a different paradigm normal skeletal adaptation to mechanical disuse would be the main reason for a bone density deviating from the average. In addition, some precision and accuracy errors in these techniques are not transparent to the wide community of bone densitometer users. The result is a large number of misclassifications of patients based on the use of densitometry for individual case finding, which may lead to a significant number of wrong treatment decisions. Consecutive drug therapy with potential side effects clearly involves ethical considerations. Intervention regimens offering the best prospects of success should include knowledge about the characteristics of bones that do not fracture, especially those of vertebrates (including humans!) adapted to a life in the wilderness, and, focus more on
prevention in context with life-style factors.

Keywords: ISBN 978-1-61668-787-8
GID: 4413; Last update: 11.04.2017