Recent studies have identified multiple factors contributing to osteoporosis and hip fracture in women. It is now possible to identify individuals who are at increased risk of osteoporotic fractures through bone densitometry, so that appropriate measures for the prevention and restoration of bone loss can be instituted. Although largely experimental, such measures are available. Prevention of hip fracture, however, may best be accomplished by preventing falls or the trauma associated with the fall in those identified at increased risk. Promising interventions are also available to reduce those risks, e.g., exercise programs, cataract surgery, and environmental modification such as hand rails and foam-backed carpeting. A major factor contributing to fall-associated fractures is a decline in mental function. Here too there may be effective measures to alter this decline in mental function and specifically the central integration of sensory input. Clinicians await with great interest the results of the proposed intervention studies of the Women's Health Initiative evaluating vitamin D and hormone replacement therapy.
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