What is Osteoporosis?
Osteoporosis is a disease that can occur in bones throughout the body, characterized primarily by a decrease in bone mass or density along with deteriorating bone quality, leading to an increased risk of fractures even from forces that would not normally cause a break in young, healthy individuals.
Why are the Elderly at Risk for Osteoporosis?
Osteoporosis causes a reduction in bone mass. In women, bone mass decreases progressively after menopause, or slightly before menopause. In men, from the age of 50 onwards, bone mass gradually decreases. When bone mass reduces to the point where bones easily break, it is called osteoporosis. Therefore, osteoporosis primarily affects the elderly or postmenopausal women, often referred to as postmenopausal osteoporosis and senile osteoporosis.
Risk Factors for Osteoporosis
Osteoporosis can be divided into 2 types, which are
1) Primary Osteoporosis Occurs in postmenopausal women or those aged 50 and above. It is the most common form of osteoporosis resulting naturally from the reduction in bone mass that occurs after menopause and past the age of 50.
Risk factors include anything that accelerates bone mass loss, such as a lack of vitamin D, insufficient calcium intake, certain medications, inadequate physical exercise, including genetic factors. Osteoporosis can be linked to genetics up to 40%. Family history of easy fractures or previous fractures from minor accidents, such as falling from a standing position causing a fracture.
2) Secondary Osteoporosis Caused by certain diseases or medications that lead to increased bone mass loss and can occur in young adults.
Warning Signs and Symptoms of Osteoporosis
Osteoporosis often does not have warning symptoms, so risk factors are used to assess the likelihood of developing the disease. Those with more risk factors are more likely to develop osteoporosis than those without risk factors. However, the first symptom encountered is a fracture. Besides risk factor assessment, bone mass testing, which is now available with modern Bone Density Mass machines, can clearly and accurately measure bone mass. In those with osteoporosis, back pain may occur due to spinal involvement, but there are many causes of back pain, so the true cause must be identified. Importantly, osteoporosis can affect every bone in the body, but the spine is often the first to be affected, making it the most commonly fractured bone in osteoporosis. Symptoms include back pain prior to a fracture, but not everyone will experience this, hence back pain is not a primary symptom of osteoporosis.
Current Treatments for Osteoporosis
Treatment for osteoporosis currently falls into 2 categories
- Non-pharmacological treatment includes:
- Patients take 1,000 milligrams of calcium per day to aid in bone formation.
- Patients take 800 – 1,000 units of vitamin D per day to promote the body’s ability to absorb calcium and enhance bone cell function.
- Patients must exercise, such as walking for 30 minutes daily or 4 – 5 times a week, as bones strengthen through stress from the spine down to the hips and feet, maintaining bone strength.
- Pharmacological treatment Currently, there are medications that can increase the reduced bone mass, divided into 2 types:
- Bone resorption inhibitors Since after the age of 50, and after menopause, bone begins to break down, medications can be used to inhibit this process, allowing bone mass or density to increase.
- Bone formation stimulants Medications stimulate bone cells to increase new bone formation, thereby increasing bone mass. These medications are more potent than those in the bone resorption inhibitor category.
Benefits of Medication
- Helps increase bone mass
- Helps restore bone strength
- Reduces the risk of future fractures
- Prevents future fractures
However, the choice of treatment with medication will vary among patients depending on the discretion of the physician