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Summary: This study explores the effect of supervised back extensor strength training on spinal pain, back extensor muscle strength, trunk-arm endurance, kyphosis, functional mobility, and quality of life (QoL) among sixty postmenopausal women with vertebral osteoporotic fractures. Purpose: To compare the effects of a 6-week supervised or home-based program of back-strengthening exercise on spinal pain, back extensor strength, trunk-arm endurance, kyphosis, functional mobility, and QoL in osteoporotic postmenopausal women with vertebral fractures. Methods: The study was designed as a randomized controlled clinical trial. Sixty osteoporotic postmenopausal women with vertebral fracture (mean age 60.3 ± 9.3 years) were included in the study. Subjects were randomly assigned into three groups (supervised program, home-based program, or control), each consisting of 20 subjects. The subjects underwent the 6-week exercise program which included strengthening exercise for the back extensor muscles. They performed three sets of 8, 10, or 12 repetitions for each of the exercises, biweekly ascending, three times per week. Spinal pain, back extensor strength, trunk and arm endurance, kyphosis, functional mobility, and QoL were measured at baseline and at the end of the exercise program. Results: Statistically significant improvements were demonstrated on spinal pain, muscle strength and endurance, functional mobility, and QoL for the supervised exercise program compared with control and home-based exercise groups (p < 0.01). Home-based exercise program did not provide a significant improvement compared with the control group except for mobility parameters of QoL. Conclusions: Six-week supervised back extensor strengthening training is superior to home-based program in terms of spinal pain, back extensor muscle strength, trunk endurance, functional mobility, and QoL for postmenopausal osteoporotic women with vertebral fractures. © 2019, International Osteoporosis Foundation and National Osteoporosis Foundation.

Background Osteoporosis and osteopenia are associated with increased fracture incidence in postmenopausal women. We aimed to determine the comparative effectiveness of various available pharmacological therapies. Methods We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ISI Web of Science, and Scopus for randomized controlled trials that enrolled postmenopausal women with primary osteoporosis and evaluated the risk of hip, vertebral, or nonvertebral fractures. A network meta-analysis was conducted using the multivariate random effects method. Results We included 107 trials (193,987 postmenopausal women; mean age, 66 years; 55% white; median follow-up, 28 months). A significant reduction in hip fractures was observed with romosozumab, alendronate, zoledronate, risedronate, denosumab, estrogen with progesterone, and calcium in combination with vitamin D. A significant reduction in nonvertebral fractures was observed with abaloparatide, romosozumab, denosumab, teriparatide, alendronate, risedronate, zoledronate, lasofoxifene, tibolone, estrogen with progesterone, and vitamin D. A significant reduction in vertebral fractures was observed with abaloparatide, teriparatide, parathyroid hormone 1-84, romosozumab, strontium ranelate, denosumab, zoledronate, risedronate, alendronate, ibandronate, raloxifene, bazedoxifene, lasofoxifene, estrogen with progesterone, tibolone, and calcitonin. Teriparatide, abaloparatide, denosumab, and romosozumab were associated with the highest relative risk reductions, whereas ibandronate and selective estrogen receptor modulators had lower efficacy. The evidence for the treatment of fractures with vitamin D and calcium remains limited despite numerous large trials. Conclusions This network meta-analysis provides comparative effective estimates for the various available treatments to reduce the risk of fragility fractures in postmenopausal women.

Objective: To describe the study design and baseline patient characteristics of the Asia and Latin America Fracture Observational Study (ALAFOS) to better understand the profile of patients receiving teriparatide during the course of routine clinical practice in Asia, Latin America, the Middle East and Russia. Methods: Prospective, observational, non-interventional study in postmenopausal women with osteoporosis who are prescribed teriparatide for up to 24 months, according to local medical standards, with a 12 month post-treatment follow-up. Measures: Demographics, risk factors for osteoporosis and fractures, history of fracture, prior osteoporosis medications, comorbidities, physical function, back pain and quality of life (QoL). Results: In total 3031 postmenopausal women (mean age 72.5 years) recruited at 152 sites in 20 countries were analyzed; 62.9% had a history of fragility fracture after age 40 (33.0% of patients with spinal, 14.2% with hip fractures). The mean (SD) bone mineral density T-scores at baseline were −3.06 (1.40) and −2.60 (1.05) at the lumbar spine and femoral neck, respectively. At entry, 43.7% of patients were naïve to prior osteoporosis treatments; 40.5% of patients reported ≥1 fall in the past year. The median (Q1; Q3) EuroQoL Visual Analog Scale (EQ-VAS) for perceived overall health status was 60 (50; 80). The mean (SD) worst back pain Numeric Rating Scale in the last 24 hours was 4.6 (3.3). Conclusions: Our data indicates that patients who were prescribed teriparatide in the ALAFOS participant countries had severe osteoporosis, high prevalence of fractures, disabling back pain and poor QoL. The frequency of patients receiving prior osteoporosis medications was lower than in previous observational studies conducted in other locations.

The patient with chronic kidney disease (CKD) represents an extreme model for arteriosclerosis, vascular calcification, and bone disorders, all of which are also associated with ageing in the general population. These pathological features are also relevant to other common chronic health disorders such as diabetes, and chronic inflammatory and cardiovascular diseases. Although management and interventions for these major risk factors are now incorporated into most public health guidelines (eg, smoking cessation and control of bodyweight and blood pressure, as well as glucose and cholesterol concentrations), some residual cardiovascular risk is not reduced by implementation of these interventions. CKD should be regarded as an atypical disease in which both traditional and novel cardiovascular risk factors have effects on outcomes. But CKD can also be viewed conceptually as an accelerator of traditional cardiovascular risk factors. Findings from research into mineral bone disorder associated with CKD (CKD–MBD) could help the medical community to better understand the vascular actions of certain molecules, such as phosphates, fibroblast growth factor 23, parathyroid hormone, sclerostin, or vitamin D and their relevance to the management of different pathologies in the general population. Importantly, these components, which are recognised in nephrology, could help to explain residual risk of cardiovascular events in the general population. Thus, achieving a better understanding of CKD–MBDs could provide substantial insight into future treatments for arteriosclerosis and osteoporosis, which are strongly associated with ageing and morbidity in the general population. © 2018 Elsevier Ltd

The Colombian Osteoporosis and Mineral Metabolism Association met in early 2017 to update the Colombian Consensus on Osteoporosis. This was first issued in 2005, and is seen as a necessary step in view of the underdiagnosed status of this disease, and the expected impact of population ageing. A technical team was formed with specialists with long experience across multiple disciplines, who were assigned to four working groups: definitions and epidemiology, diagnosis, pharmacological treatment, and non-pharmacological treatment. After a scientific literature review and a series of meetings, the definitions and recommendations are summarised in this article. © 2018 Asociación Colombiana de Reumatología

Objective: In this study, we investigated the relationships between 10 year fracture risk calculated with FRAX assessment tool and bone turnover markers (BTM) in women with diagnosed as postmenopausal osteoporosis for the first time. Materials and Methods: After exclusion of the causes of secondary osteoporosis 61 postmenopausal women diagnosed with osteoporosis for the first time were enrolled. Height and weight measurements, comorbid diseases, menopause age, and laboratory investigations were recorded. Lumbar and femur neck and femur total T scores were measured by dual-energy x-ray absorptiometry (DXA). As BTM, serum osteocalcin (OC) and urine deoxypridinoline levels were measured. 10-year fracture risk of hip and major osteoporotic fracture was calculated with FRAX assessment tool. Results: The mean age of patients was 61±39 years. Median value of menopause year was 15.13 years (min: 2, max: 40). The median 10-year hip fracture and major osteoporotic fracture risks were calculated as 1.10% (min: 0, max: 23), 6.9% (min: 3, max: 34) respectively. There was no significant relationship between BTM and fracture risk. Positive significant correlation was found between menopause year and hip fracture risk, and between menopause year and major osteoporotic fracture risks (p=0.031, 0.276; p=0.025, r=0.287). Negative significant correlation was detected between body mass index and hip fracture risk (p=0.002, r=-0.392). Conclusion: In our study, we couldn’t find relationship between BTM and fracture risks assessed by using FRAX tool in patients with initially diagnosed of postmenopausal osteoporosis. Further studies are needed to investigate the relationship between BTM and fracture risk in different patient groups. (Turkish Journal of Osteoporosis 2015;21: 58-62)

Objective: The purpose of this study was to develop a Turkish version of the mini Osteoporosis Quality of Life Questionnaire (mini-OQLQ), and assess its reliability and validity., Material and method: Sixty-four women with postmenopausal osteoporosis were included in the study. Patients who were diagnosed with secondary osteoporosis through clinical and laboratory examinations were excluded from the study. After translation process, the Turkish version of the scale was applied to each participant twice with an interval of 2 weeks. For reliability study, internal consistency (Cronbach's alpha) of mini-OQLQ total score and test-retest intraclass correlation coefficient (ICC) were calculated. Validation study was assessed by correlating the scale with QUALEFFO 41., Results: The mean age at menopause and age of patients were 45.61 +/- 6.04 and 59.91 +/- 8.69 years, respectively. Cronbach's a of the Turkish version of the mini-OQLQ was 0.898. The test-retest reliability (ICC) of the Turkish version of the mini-OQLQ was determined as 0.81 for the total score, and ranged between 0.71 and 0.84 for individual items. In terms of validity, the Turkish version of mini-OQLQ showed significant negative correlation with QUALEFFO 41 (r = -0.756; p < 0.0001)., Conclusion: The Turkish version of the mini-OQLQ was found to be reliable and valid in the evaluation of life quality of patients with postmenopausal osteoporosis.

Summary: Sixty patients diagnosed with generalized anxiety disorder and treated with either paroxetine, sertraline, or citalopram for at least 12 months were enrolled in this study, and the bone mineral density (BMD) of the patients was compared with that of 40 healthy volunteers. Selective serotonin reuptake inhibitor (SSRI) therapy in generalized anxiety disorder was found to be related with decreased BMD values., Introduction: The objectives of this study were to evaluate the effect of SSRI therapy on BMD in postmenopausal women diagnosed with generalized anxiety disorder (GAD) and to identify the effects of the duration of disease and treatment on risk factors for osteoporosis., Methods: Sixty patients diagnosed with GAD and treated with paroxetine, sertraline, or citalopram from the SSRI group for at least 12 months were enrolled. Social demographic features, the Hamilton Anxiety Scale (HAS) results, and the Hamilton Depression Scale (HDS) scores of all the patients were assessed. The BMD of the patients was measured by dual-energy X-ray absorptiometry (DXA) at the femoral and lumbar regions. The patients were divided into three groups which are the paroxetine, sertraline, and citalopram groups. The BMD of the patients was compared with that of 40 healthy volunteers., Results: The L2–L4, total lumbar vertebrae, femoral intertrochanteric, total femoral Z-scores, and femoral Ward’s region T-scores of the treatment group were lower than the median T- and Z-scores of the control group (p < 0.05). Of the treatment groups, the femoral neck, trochanteric and intertrochanteric T- and Z-scores, total femoral T- and Z-scores, and femoral Ward’s T- and Z-scores of the sertraline group were significantly lower than the BMD values measured at the identical regions in the paroxetine and citalopram groups (p < 0.05).There was a significant negative correlation between the duration of treatment and the BMD values., Conclusion: SSRI therapy in GAD was found to be related with decreased BMD values. Further randomized controlled studies are warranted to determine whether SSRI use is a risk factor for osteoporosis; such studies should investigate these factors by performing BMD assessments before treatment. © 2014, The Author(s).

Recent reports of several bone-derived substances, some of which have hormonal properties, have shed new light on the bone-cardiovascular axis. Deranged concentrations of humoral factors are not only epidemiologically connected to cardiovascular morbidity and mortality, but can also be causally implicated, especially in chronic kidney disease. FGF23 rises exponentially with advancing chronic kidney disease, seems to reach maladaptive concentrations, and then induces left ventricular hypertrophy, and is possibly implicated in the process of vessel calcification. Sclerostin and DKK1, both secreted mainly by osteocytes, are important Wnt inhibitors and as such can interfere with systems for biological signalling that operate in the vessel wall. Osteocalcin, produced by osteoblasts or released from mineralised bone, interferes with insulin concentrations and sensitivity, and its metabolism is disturbed in kidney disease. These bone-derived humoral factors might place the bone at the centre of cardiovascular disease associated with chronic kidney disease. Most importantly, factors that dictate the regulation of these substances in bone and subsequent secretion into the circulation have not been researched, and could provide entirely new avenues for therapeutic intervention. © 2014 Elsevier Ltd.

Amaç: BONCURE (Mevcut Bisfosfonat Kullanıcıları İçin Bonviva Bölgesel Avrupa Çalışması) ile daha önce günlük veya haftalık alendronat veya risendronat alan postmenopozal osteoporozu olan kadınlarda aylık ibandronat için hasta tercihinin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Bu prospektif, açık-etiketli çalışma, iki ardışık aşamadan oluşmuştur: A (tarama) ve B (tedavi) aşaması. A aşamasına kaydolan hastalar Aday Kimlik Anketi (CIQ) tamamladı. B aşamasında, Osteoporoz Hasta Memnuniyeti Anketi (OPSAT Q) tamamladıktan sonra, hastalar 6 ay boyunca aylık oral 150 mg ibandronat aldı. Tedaviden sonra, hastalar OPSAT-Q ve Tercihi Anketi tamamladı. Bulgular: Türkiye’den 223 hasta (yaş ortalaması 63,7±9,51) A aşamasına dahil edildi. Bunların arasında, 103’ü (%46,2) en az bir CIQ sorusunu "EVET" yanıtladı. Ortalama bileşik OPSAT-Q alan puanları; kolaylık (ortalama değişiklik, 15,3±17,7 puan), yaşam kalitesi (10,4±20,4 puan), genel memnuniyet (11,9±22,7 puan) ve yan etkiler (3,3±18,8 puan) için arttı. Altıncı ayda 177 hasta (%92,7) bir kez aylık doz programını tercih etti ve %99,0’u çalışma tedavisi ile uyumlu (?%80) idi. Otuz hasta (%15,6) çoğunlukla gastrointestinal olan hafif ve orta şiddette advers olay yaşadı. Sonuç: Postmenopozal osteoporozu olan kadınlar, günlük veya haftalık bifosfonat tedavisine göre aylık ibandronatı daha çok tercih etmekte ve bu tedavi ile daha memnun ve uyumlu olmaktadır. (Türk Os te opo roz Dergisi 2012;18:1-7) Aim: BONCURE (Bonviva for Current Bisphosphonate Users Regional European Trial), aimed to evaluate patient preference with monthly ibandronate in women with postmenopausal osteoporosis who previously received daily or weekly alendronate or risendronate. Materials and Methods: This prospective, open-label study consisted of two sequential stages, Part A (screening) and Part B (treatment). Patients enrolled into Part A completed the Candidate Identification Questionnaire (CIQ). In Part B, after completing the Osteoporosis Patient Satisfaction Questionnaire (OPSATQ), patients received monthly oral ibandronate 150 mg for 6 months. Following treatment, patients completed the OPSAT-Q and Preference Questionnaire. Results: A total of 223 patients (mean age, 63.7±9.51 years) were enrolled in Part A from Turkey. Among them, 103 (46.2%) answered YES" to at least one CIQ question. The mean composite OPSAT-Q domain scores increased for convenience (mean change

Aim: BONCURE (Bonviva for Current Bisphosphonate Users Regional European Trial), aimed to evaluate patient preference with monthly ibandronate in women with postmenopausal osteoporosis who previously received daily or weekly alendronate or risendronate. Materials and Methods: This prospective, open-label study consisted of two sequential stages, Part A (screening) and Part B (treatment). Patients enrolled into Part A completed the Candidate Identification Questionnaire (CIQ). In Part B, after completing the Osteoporosis Patient Satisfaction Questionnaire (OPSAT-Q), patients received monthly oral ibandronate 150 mg for 6 months. Following treatment, patients completed the OPSAT-Q and Preference Questionnaire. Results: A total of 223 patients (mean age, 63.7±9.51 years) were enrolled in Part A from Turkey. Among them, 103 (46.2%) answered "YES" to at leastone CIQ question. The mean composite OPSAT-Q domain scores increased for convenience (mean change, 15.3±17.7 points), quality of life (10.4±20.4points), overall satisfaction (11.9±22.7 points), and side effects (3.3±18.8 points). At month 6, 177 subjects (92.7%) preferred once-monthly dosing scheduleand 99.0% were compliant (?80%) with study treatment. Thirty (15.6%) subjects experienced mild to moderate adverse events, mostly gastrointestinal. Conclusion: Postmenopausal women with osteoporosis prefer and are more satisfied and compliant with monthly dosing of ibandronate than daily or weekly bisphosphonate treatment.

Objective: Osteoporosis is an important clinical condition frequently seen in postmenopausal women. It is the major cause of vertebrael and hip fractures. The incidence of osteoporotic fractures has been increasing and half of the elderly female population in most Western as well as Asian countries has been affected. The aim of this study was to determine the postmenopausal osteoporosis rate and evaluate the relationship between osteoporosis and various risk factors in postmenopausal women living in the central and rural areas of Denizli. Material and Methods: Subjects were selected randomly among postmenopausal women who were enrolled in Village Health Centers of Denizli Provincial Directorate of, Health by public announcements. We evaluated 1100 postmenopausal women out of 16113 women, aged 45-80 years. The bone mineral density of the patients was measured by quantitative ultrasound of the tibia. Subjects with T scores lower than -2.5 SD were diagnosed as osteoporosis according to the World Health Organization criteria. Results: The rates of osteoporosis in various areas ranged between 19.8% and 53.9% (mean 36.8%). The subjects were divided into two groups as with osteoporosis and without osteoporosis. Average menarche age was greater in the osteoporotic group. The subjects who had taken hormone replacement therapy (HRT) had lower osteoporosis rate. Subjects with osteoporosis had lower exercise score and had lack of sun exposure due to covering. A positive correlation was found between osteoporosis age and the duration of menopause. Conclusion: We found that the incidence of osteoporosis among postmenopausal women was very high especially in rural areas of Denizli. Age, duration of menopause, age of menarche and multiparity appeared to be important risk factors in development of osteoporosis. However, HRT, physical activity and sun exposure could prevent osteoporosis. Understanding the epidemiology and fracture risk of osteoporosis may ultimately aid in reducing the public health burden of this common disorder. © 2010 by Türkiye Klinikleri.

Brigitte Chanteranne1,2, Francesco Branca3, A Kaardinal4, K Wahala5, Véronique Braesco6, Philippe Ladroite7, Fred Brouns8, Véronique Coxam1,21INRA, Centre Clermont-Ferrand – Theix, UMR1019, Unité Nutrition Humaine, St Genès Champanelle, France; 2Univ Clermont 1, UFR Médecine, UMR1019, Unité Nutrition Humaine, Clermont-Ferrand, France; 3INRAN, Human Nutrition Unit, Ardeatina, Rome, Italy; 4TNO Nutrition and Food Research, Zeist, The Netherlands; 5Department of Chemistry, University of Helsinki, Helsinki, Finland; 6Danone Vitapole, Le Plessis Robinson, France; 7Nutrition Santé, Ravel, France; 8Eridania Beghin Say, Vilvoorde Research and Development Centre, Vilvoorde, BelgiumAbstract: The estrogenic effects of soy isoflavones (IF) on symptoms of menopause are of particular interest. The aim of the present study was to improve compliance of IF in two IF-enriched foods providing the same IF circulating levels in postmenopausal women. Forty-two healthy postmenopausal women (mean age: 53.28 years) were recruited for a randomized, crossover, multicenter trial conducted in the Netherlands, Italy and France. Over 18 days, volunteers were assigned to two groups and supplemented with two different IF-enriched foods (100 mg IF aglycones/two servings). The first group had to eat two biscuits daily for three days. After a wash-out period (11 d), they received cereal bars for three days. The second group started with the cereal bars and finished with biscuits. After IF intake, plasma and urinary levels of genistein, daidzein, O desmethyl angolensin and equol significantly increased and returned to baseline level after the washout period. There was no difference between biscuits and cereals bars intake, as shown by group values at each end of experimental period (day 4 or day 18). Both matrixes are comparable in terms of IF-circulating levels and could be used independently.Keywords: soy isoflavones, bioavailability, food processing, postmenopausal women, equol

Osteoporosis is an increasingly frequent pathology, especially due to the remarkable increase in the average age of the population. It is a skeletal disorder characterized by a reduction in bone strength which predisposes to increased fracture risk. It has been calculated that there are more than 200 million osteoporotic subjects in the world: one in three women and one in eight men over 50 years of age have osteoporosis. Although it is very widespread, only one quarter of cases are treated, and a significant percentage is not even diagnosed. As a result of these serious consequences, diagnostic and therapeutic treatment is necessary to reduce its progression. The importance of acquiring reliable epidemiological data has also been proven, in order to emphasize the effects of the condition, and to provide elements to optimize the strategies of prevention and care.

The estrogenic effects of soy isoflavones (IF) on symptoms of menopause are of particular interest. The aim of the present study was to improve compliance of IF in two IF-enriched foods providing the same IF circulating levels in postmenopausal women. Forty-two healthy postmenopausal women (mean age: 53.28 years) were recruited for a randomized, crossover, multicenter trial conducted in the Netherlands, Italy and France. Over 18 days, volunteers were assigned to two groups and supplemented with two different IF-enriched foods (100 mg IF aglycones/two servings). The first group had to eat two biscuits daily for three days. After a wash-out period (11 d), they received cereal bars for three days. The second group started with the cereal bars and finished with biscuits. After IF intake, plasma and urinary levels of genistein, daidzein, O desmethyl angolensin and equol significantly increased and returned to baseline level after the washout period. There was no difference between biscuits and cereals bars intake, as shown by group values at each end of experimental period (day 4 or day 18). Both matrixes are comparable in terms of IF-circulating levels and could be used independently. © 2008 Chanteranne et al, publisher and licensee Dove Medical Press Ltd.

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:22:41Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:35:10Z : No. of bitstreams: 1 2-s2.0-51449118673.pdf: 148092 bytes, checksum: d7050606945acb080eb73d11f60ae173 (MD5) Made available in DSpace on 2014-05-27T11:22:41Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-12-01 Objective: to investigate the quality of life among physically active post-menopausal women with and without a diagnosis of osteoporosis. Methods: a cross-sectional descriptive study was carried out through interview. All the participating women volunteered to take part of this study through previous contact by telephone. The characteristics and objectives of the interview were explained in addition to confirmation of their post-menopausal status. There were two groups of 21 volunteers each: group 1 were non-osteoporotic women (64.38 ± 4.24 years-old) and group 2 were osteoporotic women (67.81 ± 4.19 years-old). Each volunteer was asked to fulfill a preliminary form in order to register personal information, clinical history, co-morbidities and health care. Following, the SF-36 questionnaire was applied. The Wilcoxon rank-sum test was used to assess differences between the two groups. Results: there was a significant difference (p < 0.05) between both groups only with regard to the Role Physical and General Health components of the SF-36 form showing a better performance to group 1. Condusion: post-menopausal women with a diagnosis of osteoporosis that did not sustain a fracture may present a similar quality of life, as compared to non-osteoporotic post-menopausal women. Departamento de Fisioterapia Universidade Federal de São Carlos (UFSCar), São Carlos Departamento de Saúde Publica Universidade de São Paulo (USP), São Paulo Universidade Estadual Paulista (UNESP), Campus Marília, São Paulo Departamento de Estatística Programa de Pós-Graduação em Fisioterapia Universidade de São Carlos (UFSCar), São Carlos , Rua Augusto Genta 961, 17519-340 Marília SP Universidade Estadual Paulista (UNESP), Campus Marília, São Paulo

Research on the bone effects of natural phyto-oestrogens after menopause is at a relatively early stage. Published studies are few, difficult to compare and often inconclusive, due in part to design weaknesses. Currently, many questions remain to be answered including to what extent a safe daily intake may prevent postmenopausal bone loss. These questions can only be addressed by conducting well-planned, randomised clinical trials that take into consideration present knowledge in the oestrogen, phyto-oestrogen and bone fields. This review is intended to provide hints for critical decision-making about the selection of subjects, type of intervention, suitable outcome measures and variables that need to be controlled.

OBJECTIVE: The aims of this study were to evaluate the compliance with antiresorptive therapy (ART) and supplements in Spain and to analyze the validity of the different treatment compliance assessment methods. METHODS: A cross-sectional study with retrospective data collection was carried out in women starting ART, evaluating indirect objective compliance, self-reported compliance, and the Morisky-Green questionnaire. RESULTS: A total of 480 women with a mean (SD) age of 65.8 (9.2) years were studied. Of these women, 62.9% received calcium and/or vitamin D supplements in addition to ART. According to the objective compliance method, 76.9% of the women were compliers (=80%) with bisphosphonates; 69.4%, with selective estrogen receptor modulators; and 61.8%, with supplements (P < 0.01). Using the self-reported compliance, we identified 91% compliers with antiresorptive drugs and 75% with supplements. Using the Morisky-Green test, we classified 60.8% of the women as compliers with antiresorptive drugs and 48.4% with supplements. Combining the objective and self-reported compliance, 29.5% of the women did not adequately comply with ART and 56% with the drug supplements. CONCLUSIONS: With all three compliance measures, supplements were the treatment yielding the lowest percentage of compliers. Bisphosphonates constituted the treatment offering the best objective compliance: 38.2% of the women with drug supplements and between 23.1% and 30.6% of the women with ART failed to exceed the theoretical value of 80% regarded as representing good compliance.