Ageing and Bone Health
Approximately 200 million women suffer from osteoporosis worldwide. A third of women over the age of 50 years will suffer from an osteoporosis-related fracture at some point in their lives in Europe and in the United States. Annually, 1.7 million hip fractures are related to osteoporosis. Locally, the number of osteoporotic hip fractures has increased five-fold over the last 30 years.
Osteoporosis (literally – porous bone) is a condition characterised by low bone mass and increased bone fragility. Bone is a living tissue. Bone mass is a balance between new bone being produced and existing bone being lost (resorbed). During childhood and adolescence, bone is produced faster that it is resorbed. This results in a steadily increasing bone mass. Bone mass peaks in the early 20s and gradually declines after. There is a more rapid decline in bone mass in females after menopause.
Significance of Osteoporosis
The significance of osteoporosis is the case with which sufferers fracture their bones. Healthybones only break when significant forces are applied to them. Osteoporotic bones break with mild injury. Common fractures encountered with osteoporosis include vertebral compression fractures, hip fractures and wrist fractures. All these occur with simple, low energy, falls. The aim of treatment for osteoporosis is to prevent such fractures from happening.
A vertebral compression fracture is usually caused by a fall onto the buttocks and results in the front of the spine being crushed.
While a vertebral compression fracture is often left to heal on its own, hip fractures routinely require surgery to fix them or to replace the joint.
Risk Factors for Osteoporosis
Non-modifiable risk factors
- Advanced age
- Female gender and menopause
- European and Asian ancestry
- Family history of osteoporosis
- Past history of an osteoporotic fracture
- Small stature
Modifiable risk factors
- Excessive alcohol consumption
- Vitamin D deficiency
- Malnutrition (especially from low calcium intake)
Diagnosis of Osteoporosis
The diagnosis of osteoporosis made through a DXA or Bone Density scan. This is a simple investigation using X-rays to determine bone density in the hip and spine. The values are compared to that of the peak bone mass of the population (bone mass of the population in their 20s) and the diagnosis of osteoporosis is made based on how much the obtained values differ from peak bone mass.
It is recommended that ladies below the age of 60 should undergo a bone density scan if they have risk factors for osteoporosis. For those without risk factors, the bone density should be screened at the age of 65.
Act now by signing up an Osteoporosis Screening Package at $168.
- Bone Mineral Density Scan – Hip and Spine scan
- Specialist Consultation
Treatment for Osteoporosis
Multiple different drugs are available for improving bone mass. Te indication for starting treatment is established osteoporosis diagnosed with a DXA scan. These drugs are not recommended for low bone mass if the criteria for diagnosis of osteoporosis have not been met. If the probability is more than 3% for a hip fracture or more than 20% for other major fractures, treatment should also be started.
These medications work by increasing bone production, decreasing bone resorption or both. They are used in conjunction with calcium and vitamin D supplementation as well as lifestyle modifications outlined above.
The prevalence of osteoporosis is increasing. The impact of osteoporosis can be minimised with appropriate lifestyle and dietary modifications. Once diagnosed, the risk of osteoporosis fractures can be reduced with appropriate medical treatment.
Do seek advice from a medical professional if you have concerns about osteoporosis as the outcome in terms of fracture risk reduction is far better with early osteoporosis than with severe osteoporosis.