Aims
There are few studies investigating the efficacy of anti-resorptive therapy among the extremely elderly patients. This study aims to report osteoporosis treatment outcome among individuals beyond 90 years old.
Methods
A total of 30 patients with osteoporosis were identified when they turn 90 years old during clinic visit from January to June 2023. They were followed up until December 2025.
Results
Among all patients recruited, 90% are Chinese, 3.3% are Malay and 6.7% are Indians. Charlson comorbidity index ranges from 4 to 9. Clinical frailty score ranges from 2 to 7. Majority of patients (87%) stay with family. Most of patients (87%) had prior fragility fracture at the diagnosis of osteoporosis. First visit functional status ranges from home ambulant (54%), community ambulant (23%) and wheelchair bound (23%). Seven patients experienced functional decline during follow up of maximum 3 years. The average duration of treatment is 4 years (range from 1 to 10 years) and 37 % of patients started treatment before 90 years old. Majority of patients (77%) were on denosumab as of last visit due to low creatinine clearance of <30ml/min. All patients were complaint to medication and achieved treatment success with stable or significant increase in BMD and no fracture occurred during treatment.
Conclusions
This study showed that osteoporosis treatment in individuals over 90 years old is effective. Future studies to include a control group without osteoporosis treatment would provide more evidence to guide osteoporosis treatment among the extremely old.