My aunt Rita slipped on her bathroom floor and had a hip fracture. The fracture was a major one, as in, the bone had completely displaced from its position. The fall though, was a light one, on a recently mopped floor. But the impact was great. She had never hoped that this slight fall could have such grievous consequences. When she narrated the story to her doctor, they suggested her to go for a bone density test along with the measures taken to recover from the fracture. It was then found out that she had osteoporosis. Yes, osteoporosis is a silent disease and there are no major indicators. Most of the cases come to the limelight only after a fracture.
Osteoporosis is a condition in which the density and quality of bones is reduced, making them weak, brittle and more likely to fracture. Fractures of the wrist, hip, spine, pelvis and upper arm are most common in osteoporosis.
Knowing the risk factors and symptoms of osteoporosis can help us to take measures to increase bone density before the effects become devastating. So who all are at risk of osteoporosis?
Women are more predisposed to the condition because women have lighter, thinner bones than men. It is estimated that one in three women over age 50 have osteoporosis. Because of the hormone estrogen, women are predisposed to osteoporosis. Estrogen helps maintain body density; a decrease in the hormone will result in some bone loss. If bone loss is severe, a woman may experience an increase in bone fractures, loss of height, restricted mobility, or a humped back (also known as a “dowager’s hump”).
It is also known that Asian and Caucasian women are at greater risk for osteoporosis.
Women who have anorexia (an eating disorder), celiac disease (an inability to tolerate grain products), diabetes, chronic diarrhea, or kidney or liver diseases are at an increased risk for osteoporosis. Aunt Rita was on steroids for a chronic stomach disorder for so long that osteoporosis was in inevitable in her case.
Also women whose family members have had osteoporosis are at increased risk for the disease.
Treatment for osteoporosis will depend upon the results of bone density scans, age, gender, medical history and the severity of the condition. Treatment most commonly involves lifestyle changes and medications and aims to maximise bone density and reduce the risk of bone fracture.
As the body cannot make its own calcium, a diet high in calcium is necessary and helps to slow the rate of bone loss. Vitamin D is also essential as it enables calcium to be effectively absorbed by the body. Eating a balanced diet that includes calcium and vitamin D-rich foods is important in supplying the bones with the calcium required. Foods high in calcium include dairy products, dark green vegetables, beans, legumes, fish (especially sardines or salmon which are eaten with the bones), soybean products, cereals and nuts. It is recommended that at least 1000mg of calcium is taken in each day. Foods high in vitamin D include sardines, tuna, eggs and liver. However, the body harnesses its own Vitamin D through exposure to sunlight. Regular but moderate exposure to sunlight is suggested. Note, excess sun exposure poses other health risks.
It is important to take extra care with movement and daily activities in order to minimise the risk of fractures. This can include using mobility aids if unsteady on the feet, removing objects or hazards that can lead to falls (eg: loose floor rugs), installing hand rails in areas such as entranceways and bathrooms, and using non-slip mats in the bath or shower.
Treatment for osteoporosis may involve:
• Lifestyle changes, such as diet and exercise
• Taking calcium and vitamin D
• Medicines used to treat osteoporosis include: Bisphosphonates (the main drugs used to prevent and treat osteoporosis in postmenopausal women) Estrogens, teriparatide, raloxifene, and calcitonin. But they are to be bought and taken under medical supervision only.
• Exercise plays a key role in preserving bone density in older adults.