Alendronate Improves Osteoporosis in Elderly Women Living in Long-Term Care Facilities

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The summary below is from the full report titled "Alendronate Improves Bone Mineral Density in Elderly Women with Osteoporosis Residing in Long-Term Care Facilities. A Randomized, Double-Blind, Placebo- Controlled Trial." It is in the 21 May 2002 issue of Annals of Internal Medicine (volume 136, pages 742-746). The authors are SL Greenspan, DL Schneider, MR McClung, PD Miller, TJ Schnitzer, R Bonin, ME Smith, P DeLucca, GJ Gormley, and ME Melton.

What is the problem and what is known about it so far?

As women get older, their bones become more fragile (a condition called osteoporosis). As a result, the risk of fracture increases. Up to 86% of female nursing home residents have osteoporosis. Alendronate is a medication used to treat osteoporosis. Many studies have shown that treatment of osteoporosis with alendronate in younger women improves bone density and prevents fractures. No one knows if elderly women with osteoporosis can be treated effectively.

Why did the researchers do this particular study?

To find out if elderly women living in long-term care facilities could be treated effectively with alendronate and whether they could tolerate the side effects of this medicine.

Who was studied?

327 women living in 25 different nursing homes and assisted living centers across the United States who had documented osteoporosis. None of the women were bed-bound. The average age of participants was 78.5 years.

How was the study done?

Using a computerized coin flip, the researchers assigned the women to receive daily doses of either alendronate or a placebo for 24 months. All participants in both groups also received vitamin D, which helps the body retain and use calcium consumed in the diet. Calcium supplements were also given to women whose diets did not already contain enough calcium. The researchers measured bone strength (bone mineral density, or BMD) at the lower portion of the spine and at the hip bone. In addition, they did blood tests to evaluate whether the body was making new bone or losing bone. The researchers also kept track of side effects of alendronate.

What did the researchers find?

The elderly women taking alendronate had greatly improved BMD compared with women taking placebo. Blood tests also showed favorable effects on bone in the alendronate group. The occurrence of side effects did not significantly differ between the two groups.

What were the limitations of the study?

The study did not have enough participants to evaluate whether alendronate significantly decreased the number of fractures in the elderly women, and it could not determine how long medication should be given.

What are the implications of the study?

In elderly women, osteoporosis may be treated effectively by using alendronate.