Senile osteoporosis: Modern view of the problem

The article summarizes the data on senile osteoporosis and presents a clinical case of this disease. The reference sources on peculiarities of bone remodeling in senile osteoporosis are summarized; low bone formation takes place against the background of a pronounced bone resorption. The article also presents pathomorphological features of bone tissue remodeling resul­ting in pronounced impairments of the compact bone, which increase the risk of fracture. Vitamin D plays a significant role in the complex mechanism of senile osteoporosis. The data on the combined effect of vitamin D and parathormone on bone remodeling are summarized. The paper presents data on other cumulative effects of senile osteoporosis development. Against the background of ­ageing-associated systemic changes, calcium and vitamin D deficiency, increased pro-inflammatory cytokine expression, loca­lized bone disorders develop. An important link to the development of senile osteoporosis is an increased marrow adipose tissue with an intensified adipogenesis, resulting in a decrease of osteoblasts due to the toxic effects of adipokines, reduced differentiation and proliferation of osteoblasts. Age-associated immune-related mechanisms of inflammation, indirectly affecting the bone, are consi­dered. Peculiarities of the senile osteoporosis diagnostics by means of bone mineral density assessment tools are described. Despite the successes achieved in the study of senile osteoporosis development mechanisms, further research is required to explore local and systemic factors affecting bone tissue which are involved in the development of this disease.