Abstract
The elderly population has substantially increased worldwide. Aging is a complex process, and the effects of aging are myriad and insidious, leading to progressive deterioration of various organs, including the skeleton. Age-related bone loss and resultant osteoporosis in the elderly population increase the risk for fractures and morbidity. Osteoporosis is one of the most common conditions associated with aging, and age is an independent risk factor for osteoporotic fractures. With the development of noninvasive imaging techniques such as computed tomography (CT), micro-CT, and high resolution peripheral quantitative CT (HR-pQCT), imaging of the bone architecture provides important information about age-related changes in bone microstructure and estimates of bone strength. In the past two decades, studies of human specimens using imaging techniques have revealed decreased bone strength in older adults compared with younger adults. The present paper addresses recently studied age-related changes in trabecular and cortical bone microstructure based primarily on HR-pQCT and micro-CT. We specifically focus on the three-dimensional microstructure of the vertebrae, femoral neck, and distal radius, which are common osteoporotic fracture sites.
Highlights
The proportion of elderly persons in the world population has increased substantially and will continue to do so in the coming years
Osteoporosis is defined by the World Health Organization as a bone mineral density (BMD) at least 2.5 standard deviations below the mean peak bone mass of young, healthy adults as measured by dual-emission X-ray absorptiometry [5]
In an age- and sex-stratified population sample of 541 women and 490 men aged 17 to 88 years, we examined the relationship between vertebral trabecular volumetric BMD and age [13]
Summary
The proportion of elderly persons in the world population has increased substantially and will continue to do so in the coming years. Osteoporosis is a common disease of the elderly [2,3,4], characterized by low bone mass and microstructural deterioration of bone tissue, with an increased fracture risk. The effects of age on fracture risk could be due to a number of factors, including bone microstructural deterioration and possible changes in bone material properties, such as the composition and degree of collagen cross-linking. The present paper discusses recently studied age-related changes in trabecular and cortical bone microstructure, based primarily on high resolution peripheral quantitative CT (HR-pQCT) and micro-CT. As these changes take a somewhat different course in females and males and in different skeletal sites, these variations are reviewed
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