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Type II (“Senile”) Osteoporosis

- See: spine in osteoporosis

- Discussion:
    - caused by long term calcium deficiency;
         - there is an age related decline in renal production of 1,25 Vit D with subsequent hyperparathyroidism & bone loss;
    - these pts have already lost most of the bone they ever will lose;
    - they differ little in bone density from peers w/o frx,
    - affects patients over age of 75;
    - equal loss of cortical and trabecular bone;
    - low bone turnover;
    - in type II osteoporosis, frx occur most often in vertebrae & femoral neck, followed by frx of pelvis, humerus, & tibial fractures;

- Treatment of Type II:
    - no evidence that estrogen or calcitonin is beneficial in these patients;
    - treatment consists primarily of calcium supplementation (because of impaired Ca absorption) & instruction in measures that decr risk of falls;
          - it also makes sense that these patients be give 1,25 Vit D

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