STUDY: Estrogen therapy significantly improves bone density in elderly women

Tuesday, August 14th 2001, 12:00 am
By: News On 6

CHICAGO (AP) _ Estrogen replacement therapy significantly improved bone density in frail, elderly women, according to a study that suggests beginning the treatment even late in life may be beneficial.

The findings are encouraging, though more research is needed to determine whether the improved bone density helps prevent fractures in elderly women, said Dr. Dennis Villareal, the study's lead author and a professor of geriatrics and gerontology at Washington University School of Medicine in St. Louis.

The study, which appears in Wednesday's Journal of the American Medical Association, is believed to be the first to focus on estrogen replacement therapy in frail women over 75 _ those at greatest risk of fractures.

``Women over 75 constitute a rapidly growing segment of the population at risk of losing functioning independence,'' Villareal said.

He said it was believed that bone loss peaked after menopause, then slowed as women got older. But recent studies have suggested that bone loss continues and may even accelerate as women age.

There were questions about whether estrogen could improve bone density in frail, elderly women _ and whether they could tolerate it, researchers said.

The study found that few of the women experienced side effects from the estrogen. It also found similar and possibly even greater effects on bone density in older women compared to younger women.

Patients and their doctors must weigh the potential benefits of estrogen therapy with the risks, which include a slightly elevated chance of breast cancer, Villareal said.

``The bone mineral density question was answered definitely,'' in his study, Villareal said. ``Even in very old women, estrogen replacement therapy has the same beneficial effects.''

Daniel Brauner, an associate professor of clinical medicine in geriatrics at the University of Chicago, said the study appeared to settle questions about whether older women would respond to estrogen.

``Now the question would be, should this change our practices at this time?'' he said. ``If (estrogen therapy) makes the bones stronger, it may decrease the rate of fracture, but that remains to be studied.''

Falling is the primary cause of fractures among the elderly, so training muscles and improving balance and gait may be equally or more important in preventing fractures than medication, he said.

Villareal said larger studies are needed to see if estrogen and exercise together decrease fracture risk.

In the study, 67 women age 75 and older who had mild to moderate physical frailty were randomly assigned to receive estrogen or a placebo for nine months. None had received estrogen previously.

At the end of the study, bone density in the lumbar spine had increased an average of 4.3 percent among women who received estrogen _ similar to or higher than increases noted among younger women in previous studies.

Bone density in the women's hips increased an average of 1.7 percent, and among the women who adhered most closely to the hormone replacement therapy, femoral neck bone density increased 2.5 percent.