Comprehensive clinical review of osteoporosis in older adults: Diagnosis, management, and a UAE primary care perspective.

Osteoporosis is a progressive skeletal disorder characterized by reduced bone strength and an increased risk of fragility fractures, particularly among older adults. With rising life expectancy, osteoporosis has become a significant public health concern. In the United Arab Emirates (UAE), factors such as vitamin D deficiency, sedentary lifestyles, and a high prevalence of chronic diseases contribute substantially to disease burden. To provide a comprehensive, primary care-focused narrative review of osteoporosis in older adults, emphasizing diagnosis, fracture risk assessment, and evidence-based management strategies relevant to ambulatory care settings in the UAE. This narrative review synthesizes evidence from international clinical guidelines, systematic reviews, and peer-reviewed literature related to osteoporosis screening, diagnosis, and management. Particular emphasis is placed on approaches applicable in primary care practice. Osteoporosis often remains clinically silent until a fragility fracture occurs. Diagnosis relies on bone mineral density assessment using dual-energy X-ray absorptiometry (DEXA), supported by clinical risk evaluation tools such as FRAX. Effective management includes pharmacological therapy, optimization of calcium and vitamin D intake, lifestyle modification, and fracture prevention strategies. Early identification and proactive management of osteoporosis in primary care are essential to reduce fracture risk and preserve functional independence in older adults. Primary care physicians play a pivotal role in screening, prevention, and long-term management within the UAE healthcare system.