Bone Health and Osteoporosis Management in the Elderly: A Review of Guidelines and Orthopedic Implications.

Osteoporosis, a systemic skeletal disorder characterized by reduced bone mass and structural deterioration, predominantly affects the elderly and leads to increased fracture risk and substantial healthcare burdens. Despite established clinical guidelines, managing osteoporosis in older adults remains challenging due to comorbidities, polypharmacy, and variable guideline adherence. This review aims to critically examine current osteoporosis management strategies, with a focus on guideline recommendations, diagnostic tools, pharmacological and non-pharmacological interventions, and orthopedic implications in the elderly population. A comprehensive literature search of recent high-quality studies and clinical guidelines was conducted, emphasizing evidence-based practices in screening, treatment, and rehabilitation. Key findings reveal that while tools like Fracture Risk Assessment Tool (FRAX) and Dual-energy X-ray Absorptiometry (DXA) remain central to fracture risk assessment, emerging imaging modalities and digital health technologies offer enhanced diagnostic precision. Nutritional supplementation, tailored exercise, and pharmacotherapy, including novel anabolic agents, form the cornerstone of effective fracture prevention. The orthopedic management of fragility fractures requires specialized surgical techniques and multidisciplinary rehabilitation to improve functional outcomes. Challenges include medication adherence, managing comorbidities, and integrating personalized care. The review highlights the need for a holistic, interdisciplinary approach combining medical, surgical, and rehabilitative care, supported by patient education and technological advancements. Optimizing osteoporosis management in the elderly is crucial to reducing fracture incidence, minimizing morbidity, and enhancing quality of life in aging populations.