Introduction

The total number of older adults in Turkey is striking, amounting to around 8 million, and this translates into considerably higher numbers of cases of osteoporosis (OP) and fractures in older adults.

Objectives

We aimed to outline the current situation of OP in older adults in Turkey and investigate the differences between Turkey and a representative developed European country (Belgium), in terms of the screening, diagnosis, and treatment of OP. Our intention in this regard was to identify areas in need of improvement and subsequently to make a clear call for action to address these issues.

Methods

Herein, considering the steps related to the OP approach, we made a complete review of the studies conducted in Turkey and compared with the literature recommendations.

Results

There is a need for a national osteoporotic fracture registry; measures should be taken to improve the screening and treatment of OP in older males, such as educational activities; technicians involved in dual-energy X-ray absorptiometry (DXA) scanning should undergo routine periodic training; all DXA centers should identify center-specific least significant change values; all older adults should be considered for routine lateral dorsolumbar X-ray imaging for the screening of vertebral fractures while ordering DXA scans; the inclusion of vertebral fracture assessment (VFA) software in DXA assessments should be considered; screening using a fracture risk assessment tool (FRAX) algorithm that is specific to Turkey should be integrated; the fortification of foods with vitamin D is required; the high fracture risk by country-specific FRAX algorithm and the presence of falls/high fall risk should be integrated in reimbursement terms; and finally, more “fracture liaison services” should be established.

Conclusions

We suggest that the practical consideration of our suggestions will provide considerable support to the efforts for combating with the adverse consequences of OP in society. This approach can be subsequently modeled for other populations to improve the management of OP globally.

中文翻译：

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土耳其老年人骨质疏松症治疗的现状：需要通过其他人群模型改进的领域

介绍

土耳其的老年人总数惊人，约为 800 万，这意味着老年人骨质疏松症 (OP) 和骨折病例的数量要多得多。

目标

我们旨在概述土耳其老年人 OP 的现状，并调查土耳其与具有代表性的欧洲发达国家（比利时）在 OP 筛查、诊断和治疗方面的差异。我们在这方面的意图是确定需要改进的领域，然后明确呼吁采取行动解决这些问题。

方法

在此，考虑到与 OP 方法相关的步骤，我们对在土耳其进行的研究进行了全面回顾，并与文献建议进行了比较。

结果

需要建立国家骨质疏松性骨折登记处；应采取措施改进老年男性 OP 的筛查和治疗，例如开展教育活动；参与双能 X 射线骨密度仪 (DXA) 扫描的技术人员应接受常规定期培训；所有 DXA 中心应确定特定中心的最小显着变化值；在订购 DXA 扫描时，应考虑对所有老年人进行常规侧腰背 X 射线成像以筛查椎体骨折；应考虑在 DXA 评估中加入椎体骨折评估 (VFA) 软件；应整合使用​​土耳其特有的骨折风险评估工具 (FRAX) 算法进行筛查；需要用维生素 D 强化食物；国家特定 FRAX 算法的高骨折风险和跌倒/高跌倒风险的存在应纳入报销条款；最后，应该建立更多的“骨折联络服务”。

结论

我们建议，对我们的建议进行实际考虑，将为应对 OP 在社会上的不利后果的努力提供相当大的支持。这种方法可以随后为其他人群建模，以改善全球 OP 的管理。