Clinical recommendation	Evidence rating	References
Prevention of fractures and treatment of osteoporosis
Older persons at risk of falls should consider exercise, physical therapy, home hazard assessment, and withdrawal of psychotropic medication to decrease fall risk.	B	26, 27
Daily vitamin D supplementation (at least 700 to 800 IU), with or without calcium, should be used to decrease fracture risk in persons 60 years and older.	B	15, 31
Bisphosphonates should be used to prevent osteoporotic fractures (see Table 5 for specific indications).	A	14, 16, 17, 21, 33, 34
Raloxifene (Evista) can be used to prevent vertebral fractures in postmenopausal women with osteoporosis, especially if at high risk of breast cancer.	A	22, 33, 34
Calcitonin (Miacalcin) can be used to prevent recurrent vertebral fractures in postmenopausal women.	B	23, 34
Teriparatide (Forteo) can be used to prevent vertebral and nonvertebral fractures in postmenopausal women with prior vertebral fractures.	A	24, 34
Screening
The following populations should be screened for osteoporosis:
All women 65 years and older	A	2, 3
Selected postmenopausal women and men 50 to 69 years of age with risk factors for fracture	C	2, 13
All men 70 years and older	C	2, 13