Treatment for Osteoporosis in Young Adults with Cerebral Palsy

Initial Assessment and Risk Factors

A Z-score of less than -2.0 SD confirms "low BMD for chronological age" or "below the expected range for age" in a young adult with cerebral palsy, according to the American College of Radiology 1, 2
Immobilization is a significant risk factor for osteoporosis, particularly in quadriplegic/paraplegic patients with cerebral palsy, as stated by the American College of Physicians 3

The American College of Physicians recommends ensuring adequate calcium intake (>1000 mg/day) through diet or supplements to support bone health 4
Maintaining vitamin D supplementation (800-1000 IU/day) is recommended to support bone health, according to the American College of Physicians 4

The American Gastroenterological Association recommends measuring BMD yearly to assess treatment response, with a strength of evidence level of moderate 5
Treatment should continue for at least three years, with consideration for long-term therapy if BMD continues to improve, as suggested by the American Gastroenterological Association 5
If BMD falls >4% per year in two successive years on current treatment, the American Gastroenterological Association recommends considering changing to another drug 5