Osteoporosis: A silent Bone Thief in Elderly

Seniors often grapple with multiple health issues, and among the common concerns is osteoporosis. On the annual occasion of World Osteoporosis Day, marked each year on 20th October, a year-long campaign commences, aiming to enhance global awareness about osteoporosis prevention, diagnosis, and treatment. Today, we will talk about osteoporosis, a common bone disease that predominantly affects seniors, causing bones to become fragile and prone to fractures.

Causes:

Ageing: One of the primary causes of osteoporosis is the natural ageing process. As individuals grow older, bone density naturally decreases, making bones more susceptible to fractures.

Hormonal Changes: Hormonal changes in both men and women can lead to osteoporosis. In women, the decline in oestrogen levels during menopause is a significant factor. In men, reduced testosterone levels can contribute to bone loss.

Family History: A family history of osteoporosis can increase the risk. If close relatives have experienced the condition, it’s essential to be vigilant.

Nutritional Factors: Poor nutrition, particularly a lack of calcium and vitamin D, can lead to weaker bones. An inadequate intake of these essential nutrients affects bone density.

Inactivity, smoking and consuming alcohol: A sedentary lifestyle and a lack of weight-bearing exercise can contribute to bone loss. Regular physical activity helps maintain bone density. Smoking and consuming alcohol significantly contributes.

Medical Conditions: Certain medical conditions, such as rheumatoid arthritis, hyperthyroidism, and gastrointestinal diseases, can impact bone health and contribute to osteoporosis.

Symptoms:

Osteoporosis is often called a “silent disease” because it progresses without symptoms until a fracture occurs. Common fractures associated with osteoporosis include those of the wrist, hip, and spine. Some potential symptoms and warning signs may include:

Back Pain: Osteoporosis-related vertebral fractures can lead to chronic back pain and a stooped posture.

Height Loss: A loss of height over time may be noticeable due to vertebral compression fractures.

Fractures: Individuals with osteoporosis are more prone to fractures, which can occur even with minor trauma or stress.

Diagnosis:

Osteoporosis is typically diagnosed through bone density testing, which measures bone mineral density (BMD). Dual-energy X-ray absorptiometry (DXA) scans are commonly used to assess BMD. Based on the T-score from the DXA scan, which compares bone density to that of a healthy young adult, individuals are categorised into normal, osteopenia (low bone density), or osteoporosis.

Prevention:

Preventing osteoporosis is crucial, especially for seniors. Here are some preventive measures:

A Balanced Diet: Ensure an intake of calcium-rich foods like dairy products, leafy greens, and fortified foods. Adequate vitamin D is necessary for calcium absorption.

Regular Exercise: Engage in weight-bearing exercises like walking, jogging, and resistance training to improve bone density and muscle strength.

Healthy Lifestyle Choices: Avoid smoking and alcohol intake. Smoking and alcohol consumption can weaken bones.

Bone Density Testing: Regular bone density tests can help identify early signs of osteoporosis.

Medications: In some cases, doctors may recommend calcium and vitamin D to manage osteoporosis or improve bone health.

Treatment:

When osteoporosis is diagnosed, treatment focuses on slowing bone loss, preventing fractures, and relieving pain. Treatment options may include:

Medications: Bisphosphonates, hormone-related therapies, and newer medications like denosumab can help reduce bone loss and fracture risk.

Calcium and Vitamin D Supplements: These supplements may be prescribed to ensure the body gets the essential nutrients for bone health.

Lifestyle Modifications: Fall prevention strategies, such as improving home safety, can reduce the risk of fractures.

Physical Therapy: Physical therapists can help with exercises to improve posture, strengthen muscles, and reduce pain.

Pain Management: For individuals experiencing discomfort, pain management techniques may be recommended.

Osteoporosis in seniors is a common yet manageable condition. Awareness, prevention, and timely intervention are key to maintaining bone health in older adults. Seniors should discuss their bone health with a doctor and develop a personalised plan for osteoporosis prevention and management.

Dr Zubair Saleem is a Senior Geriatric Consultant and Gerontologist