Ageism in Studies on the Management of Osteoporosis

OBJECTIVES: To review the literature to assess whether the fact that osteoporosis is chiefly considered a disease of the older population was reflected in research in the area of the management of osteoporosis and to determine the extent of ageism in studies on the management of osteoporosis. DESIGN: Review. SETTING: All randomized control trials on the management of osteoporosis entered in the Cochrane Library Database that reported mean age were included. Exclusion criteria were also examined. Of 284 randomized control trials identified, 102 were eligible for inclusion. PARTICIPANTS: Older adult trail participants. MEASUREMENTS: Mean age of participants and exclusion criteria used were analyzed. RESULTS: The mean age of all participants was 64.0, despite the fact that the average age at hip fracture is 83 for women and 84 for men. Overall, the mean age of those presenting with hip fractures is 84.8. Twenty-four (23%) of the 102 trials used older age as an exclusion factor. Other exclusion factors were long time since menopause, impaired cardiac or pulmonary function, dependent in ambulation, any severe comorbidity, dementia or any cognitive impairment, recent history of peptic ulcer disease or erosive gastric disease, uncontrolled hypertension, and psychiatric illness. CONCLUSION: These data show a distinct difference between the mean age of participants in studies of the management of osteoporosis and the mean age of those presenting with hip fractures. Given that osteoporosis is the leading cause of hip fractures, this finding could have a significant effect on future studies in this area. It would follow that future research should include a cohort of an age that is more reflective of those most likely to experience the adverse effects of osteoporosis.