Pathological calcium metabolism in the elderly
Caniggia, A.; Loré, F.
Panminerva Medica 28(1): 1-4
1986
ISSN/ISBN: 0031-0808 PMID: 3960579 Document Number: 270785
Bone remodeling is a continuous process which involves the skeleton even in the extreme age of life. In the elderly bone resorption predominates over bone formation; as a consequence of this there is a progressive loss of bone mass in elderly people of both sexes, which has been interpreted, in terms of homeostatic adaptation, as aimed to the maintenance of normal plasma calcium levels in subjects with a slowly progressive impairment of intestinal calcium transport. Other Authors believe that a mild hypocalcemia can stimulate parathyroid activity leading to an increase in parathyroid hormone secretion and consequently in bone resorption. All these patterns can be described as senile osteoporosis. In a great number of postmenopausal women bone loss is of particular severity in the spine and leads to symptomatic osteoporosis: in these subjects the intestinal calcium absorption is impaired, bone mineral content decreases rapidly and vertebral crush fractures develop: this is a well defined disease known as postmenopausal osteoporosis. In a number of elderly subjects the impairment of intestinal phosphate absorption is the predominant feature, as a conseqence of disturbances in vitamin D availability or metabolism. The defect in phosphate metabolism can result in osteomalacia or in mixed patterns of osteoporosis and osteomalacia. In these cases the clinical diagnosis is sometimes difficult.