Crippling India’s elderly

Dangerously under-recognized, osteoporosis quietly becomes a public-health emergency in India. Just shift your attention to this: bone pain, backache, stooped posture, and fractures are often dismissed as an unavoidable part of ageing in our society. It is particularly the case in postmenopausal women and elderly men. It’s this misconception that costs thousands of Indians their mobility, independence, dignity, and in many cases, their lives.

We must remember that Osteoporosis is not a normal consequence of ageing. It is a serious, chronic disease where bones gradually lose strength, thus becoming fragile. What makes it so lethal is its silence. Most patients feel perfectly well until a simple fall while walking, slipping in the bathroom, lifting a bucket, or even coughing leads to a fracture. By the time the first fracture occurs, the disease has usually been present for years. Postmenopausal women in India are at the highest risk. Early menopause, nutritional deficiencies, repeated pregnancies, prolonged breastfeeding, lack of calcium and vitamin D intake, and limited outdoor activity all contribute to rapid bone loss. Sadly, women often ignore their symptoms, prioritizing family over health. For many, the first diagnosis of osteoporosis is made only after a devastating hip or spine fracture.

There is a widespread myth that osteoporosis affects only women. Fact of the matter is that elderly men—particularity those with poor nutrition, smoking history, alcohol use, diabetes, or chronic illnesses—are equally vulnerable. When men fracture, outcomes are often worse due to delayed diagnosis and poor rehabilitation. In the Indian context if there is a hip fracture in an elderly man it usually marks the beginning of dependence, and consequent health decline, and that too rapidly.

Osteoporotic fractures—especially of the hip and spine—are not minor injuries. In India, a hip fracture can cause a person to go bedridden overnight. Prolonged hospital stays, financial burden, fear of falling again, chronic pain, and depression follow. Many patients never regain their previous mobility. Mortality rates after hip fractures remain alarmingly high, particularly in elderly men. Spinal fractures silently cause loss of height, severe back pain, stooping posture, breathing difficulty, and reduced capacity to perform daily activities. These patients often suffer in silence, believing it to be “old age.”

Osteoporosis does not just break bones—it breaks families emotionally and financially, and overwhelms caregivers.

Remember, the tragedy is preventable.

The most painful truth is that osteoporosis is both preventable and treatable. Early identification through clinical risk assessment and bone density (DEXA) testing can detect osteoporosis before fractures occur. Timely treatment can reduce fracture risk dramatically and preserve independence.

Here is what every Indian family must know.

Bone health must be protected across life, but intervention at any age makes a difference:

• Ensure adequate calcium and vitamin D, through diet and supplements when advised.
• Encourage daily weight-bearing exercise such as walking, stair climbing, and simple strength training.
• Promote sunlight exposure, especially in elderly women who remain indoors.
• Prevent falls by improving home safety—non-slip bathroom floors, grab bars, proper lighting, and supportive footwear.
• Avoid tobacco and excessive alcohol, both major contributors to bone loss.
• Regular health check-ups for elderly parents should include bone health assessment.

Good news is that osteoporosis is no longer untreatable:

• Bone-strengthening medicines can significantly reduce fracture risk when taken correctly and for the recommended duration.
• Advanced injectable therapies are available for high-risk patients and those with previous fractures.
• Physiotherapy and rehabilitation after fractures restore confidence, balance, and mobility.
• Any patient with a fragility fracture must be evaluated and treated urgently to prevent the next fracture—which is often more severe.

India is ageing rapidly. If osteoporosis continues to be ignored, we are heading towards an epidemic of disability, dependency, and preventable deaths among our elderly—especially postmenopausal women and senile men.

Persistent back pain, loss of height, stooped posture, or fractures after trivial trauma should never be ignored. Awareness, early diagnosis, and timely treatment can transform old age from suffering to strength, independence, and dignity.

Dr Ansarul Haq Lone, Assistant Professor, Orthopaedics & Sports Medicine: Hospital for Bone and Joint Surgery, Srinagar