The part "Special pharmacology of the aged" of this guideline contains 
recommendations for typical conditions in the family doctors practice: in the 
January issue 2009 dementia and Morbus Parkinson, in this issue osteoporosis and 
urinary incontinence and in the next issue rectal incontinence and obstipation. 
This issue of the IJCPT contains the third part of the Pharmacotherapy 
guidelines for the aged by family doctors for family doctors. Part 3: 
Osteoporosis and urinary incontinence. Osteoporosis is a systematic disease 
characterized by low bone mass and declining bone structure. Exercise, adequate 
diet, nicotine abstinence as well as reduction of alcohol consumption may 
counteract the progression of the disease. Osteoporosis manifests in bone 
fractures with minimal trauma. Attention must be given to the risk of falling, 
e.g., by avoiding drugs that increase the risk of falling: e.g., psychotropic 
agents, analgesic drugs and antiarrhythmic agents. Specific osteoporosis 
medication e.g. calcium, vitamin D, biphosphonates and SERM (selective estrogen 
receptor modulators) is evaluated by family doctors according to indication, 
dosage, contraindications, long-term therapy and nature of any fracture. 
Duration of therapy is at least 3 - max. 5 years followed by reassessment of 
indication. There are 3 types of urine incontinence (urge-, stress-, and 
overflow-incontinence). Another standardization of urinary incontinence follows 
dysfunctions of the pelvic floor: detrusor muscle-dependent, due to sphincter 
spasm, prostate gland dependent. Urge incontinence with a dysfunction of the 
detrusor muscle is the most common type. Mixed types are frequent. Non-drug 
measures (e.g. pelvic muscle training, bladder training, toilet training are 
first choice treatments. Drug therapy (estrogen, imipramine) are without proven 
effect.