ABSTRACT
Whereas the development and maintenance of adequate bone mineralization and strength are critically important throughout the life cycle, the later years of adulthood are when problems with bone health can be most devastating. Osteoporosis and associated fractures constitute a major health concern in terms of both prevalence and impact on health, function, and quality of life (QOL) in older adults. The impact of this disabling disease increases dramatically with age, and women aged 80 years or more are at great risk for fracture (Gehlbach et al., 2007). Moreover, the increasing rates of fracture exceed those explained by demographic changes alone (Boonen et al., 2008),
Introduction .................................................................................................................................... 415 Bone Health of Older Adults: Background and Impact ................................................................. 416
Osteoporosis: Prevalence and Health Impact ....................................................................... 416 Osteoporosis: Impact on Quality of Life .............................................................................. 417
Nutritional Determinants of Bone Health in Late Life .................................................................. 417 Vitamin D and Ca ................................................................................................................. 418
Changes in Status and Requirements with Age ........................................................ 418 Dietary and Supplemental Sources ........................................................................... 419
Other Dietary Factors That Affect Bone Health ................................................................... 419 Vitamin K .................................................................................................................. 420 Protein .......................................................................................................................420 Vitamin A .................................................................................................................. 421 Phosphorus ................................................................................................................ 421 Sodium ......................................................................................................................421 Alcoholic Beverages ................................................................................................. 421
Nutritional Interventions to Preserve BMD and Prevent Fractures ............................................... 421 Trials of Vitamin D and/or Ca Supplementation .................................................................. 421 Summary of Evidence and Implications for Clinical Practice .............................................. 423
Special Considerations Related to Bone Health in Older Adults ...................................................424 Frailty, Inactivity, and Low Bone Mass ................................................................................424 Obesity and Sarcopenic Obesity ...........................................................................................424 Age-Related Complexities of Therapeutic Interventions ..................................................... 425
Summary ........................................................................................................................................ 426 References ...................................................................................................................................... 426
emphasizing the importance of bene„cial nutrients as modi„able determinants of bone health in later life.
