Osteoporosis is a common condition in older adults, which can lead to a cascade of serious fragility fractures if left untreated. This report describes the case of an 86-year-old woman with a history of osteoporosis, previously treated with denosumab, which was discontinued due to jaw osteonecrosis. She was admitted to the orthopedics ward with a right-sided hip fracture (HF) and subsequently discharged to a rehabilitation facility after surgical repair, without resuming anti-osteoporotic therapy. Two months later, she was re-admitted to the orthogeriatrics ward with a contralateral HF. Postoperatively, she developed delirium, which further compromised her cognitive and functional recovery. Once again, anti-osteoporotic treatment was not initiated during hospitalization but was instead postponed until the outpatient care phase. This case highlights the risks of anti-osteoporotic treatment discontinuation, a common gap in secondary fracture prevention among older adults. Timely initiation of anti-osteoporotic therapy is essential to prevent future fractures, and the risk-benefit balance of treatment should be carefully considered not only when prescribing, but also when deciding to withhold therapy.
KEY WORDS: Hip fracture, older adults, osteoporosis, anti-osteoporotic treatment.
