Osteoporosis
This week we’ll investigate a disease process that can lead to one of the most dreaded problems for an older adult - a hip fracture. Osteoporosis is a disease that develops from bone loss and re-organization of how our bones are knit together. Our normal bone structure is like a tiny three-dimensional fishnet, and osteoporosis is like a pair of scissors that come to cut that fishnet away. Eventually the scissors snip enough of the fishnet that our bones become weak, less dense, and very fragile; all of which increases our risk of breaking a bone.
Bone health starts at birth and continues throughout a person’s life, but osteoporosis is primarily a disease of aging. A person’s bone strength and mass peaks around age 25, and after that there is a gradual decline. This decline accelerates for women after menopause, and one foundation estimates that 50% of women over 50 will break a bone due to osteoporosis!
Osteoporosis is a “silent” disease, meaning that there are many people who have it and don’t know about it. Usually it is discovered on accident when looking for something in the form of a compression fracture of the lower spine seen on an X-Ray. A common story is of a person who has a cough or maybe their hips are hurting from arthritis and their doctor orders an X-Ray of the chest or pelvis and voila, an old fracture of the middle or lower spine is there. These findings are called fragility fractures, and when they are discovered, a diagnosis of osteoporosis is made.
Although risk of osteoporosis increases with age, and seemingly exponentially for women after menopause, it is preventable and treatable. The National Academy of Medicine recommends a person have around 1200mg of calcium per day, through dietary sources if possible, but through supplements if unable to achieve that through diet. Another recommendation for bone health is to have a good level of vitamin D. This can be measured at a primary care physician’s office, and the level should ideally be over 30 (ng/dL). Screening for the disease before a fragility fracture occurs may be one of the most important steps; a person’s health history helps determine when that screening should occur but it should absolutely occur for every woman at age 65.
Finally, practical steps a person can take to prevent this awful, limiting disease from occurring is to exercise. Resistance based or balance based, the most important thing is for the exercise to be weight-bearing. That means simple things like walking every day puts stress on the bones and helps them to stay strong!
Key Points:
Osteoporosis is a disease of weakening bones and the risk of developing it increases as we age
Osteoporosis can be prevented with the right amount of calcium, vitamin D, exercise, and checking a bone density test at the right time for you
Talk to your primary care physician about when you should be checked for osteoporosis
