All About Osteoporosis
Contrary to popular belief, osteoporosis is not a disease that only afflicts ‘old ladies’. While it’s true that more than half of women in New Zealand aged 60 years or older will be affected by osteoporosis, did you know that a third of men in the 60+ age bracket are also at risk, as are women as young as 25?
Osteoporosis is a disease that impacts bone density and quality, weakening the skeleton and increasing the risk of bone fractures. Often the loss of bone density is gradual and has no symptoms until the person experiences a fracture.
Osteoporosis is thus often referred to as a ‘silent disease’. The most common fractures associated with osteoporosis are in the wrist, hip, and spine. Spinal fractures (or vertebral compression fractures) can cause immense pain, and result in a gradual loss of movement and inability to carry out daily tasks. Hip fractures are also serious and can lead to long stays in hospital, chronic pain, and ultimately loss of independence.
Osteoporosis is a major health issue, costing New Zealand an estimated $1.1 billion each year. While there is no cure for osteoporosis, you can modify your lifestyle to help reduce the risk of developing the disease. Lifestyle modifications can also help if you already have the disease.
Risks for Women
Bone loss increases as people age, and women can experience significant bone loss after menopause, when oestrogen levels decline. More women are hospitalised due to osteoporosis-related hip fractures than through breast cancer!
Remembering that low bone mass can occur at an early age, it’s important to go to the doctor if you have any of the known risk factors. If you find you are at risk of osteoporosis, it’s a good idea to modify your lifestyle as quickly as possible.
There are usually no symptoms of osteoporosis until a fracture or bone break occurs. By then the affected bone has already been significantly weakened. Your doctor will make a clinical assessment which may include the FRAX® risk assessment tool, developed by the World Health Organisation to evaluate patient fracture risks. Based on the results, your doctor may decide to carry out a bone mineral density test (also known as a BMD).
If the BMD results indicate osteoporosis, it does not automatically mean that you will suffer a fracture. Your doctor will discuss therapy and treatment options to slow down the occurrence of bone loss. Prescription medications for osteoporosis bind to bone surfaces, providing a protective coat to improve bone density and slow bone loss, halving the risk of fractures. Both subsidised and nonsubsidised medications are available for osteoporosis.
Your doctor can help you choose the best medication for your situation if you are diagnosed with the disease. Calcium and Vitamin D supplements can also be helpful to treat osteoporosis, but do consult your doctor or GP before taking calcium in a supplement form.
This is particularly important for people with known vascular disease and those over 70 years of age.
A good diet, regular exercise, taking prescription medication as required, and reducing the risk of falls are all important factors to keep people who have osteoporosis safe.
Following are some tips to help you or the person you support stay healthy and safe on a day to day basis.
- Reduce the risk of falls … keep your house free of clutter and any possible hazards.
- Try not to let pets walk closely around your feet; you can easily trip and fall over them.
- Ensure that mats and rugs are either securely fastened to the floor or remove them altogether; it’s so easy to trip over bunched up mats.
- Ensure you have good lighting in all of your rooms, at entries, and along garden paths.
- Install grab rails in your bathroom or toilet to help prevent falls, and to assist while moving around.
- Don’t try tiptoeing or standing on chairs: use a grabber or reacher instead.
- Avoid lifting heavy objects such as big bags of potatoes or garden fertilisers; ask for help if necessary.
- Maintain a healthy diet. Try to eat foods that are high in calcium. Dairy products such as milk and cheese are rich in calcium and help to strengthen bones.
- Wear a hip protector: thin oval plastic discs that fit over the hip area in specially designed clothing, and absorb shocks in the hip area if you fall.
- Spend at least 30 minutes per day out in the sunshine. Your body needs Vitamin D to absorb calcium, made in the skin when it is exposed to light. If you are unable to get outside or aren’t getting enough exposure to sunshine, it might be a good idea to take Vitamin D supplements, but do check with your doctor or medical professional first.
Who’s At Risk?
Some of us are more likely than others to develop osteoporosis. It’s important to remember that the disease is not just a result of ageing, but develops from a combination of factors, including age, genetics, lifestyle, hormones, medications, and medical conditions.
Common Risk Factors
- People aged 50+.
- Being female.
- Women who went through early menopause or who are postmenopausal.
- A previous history of bone fractures.
- Family history of osteoporosis.
- People who are thin or ‘small-boned’.
- A low level of dietary calcium (less than four servings of dairy products per day).
- Heavy drinkers of alcohol.
- People who spend less than 30 minutes outdoors in the sunlight each day.
- People who do less than 30 minutes of physical activity each day.
Some osteoporosis risk factors can be modified through lifestyle changes, such as reducing your alcohol intake to two or fewer drinks per day, ceasing smoking, increasing the amount of calcium and Vitamin D in your diet (milk and cheese are particularly good for you), and undertaking regular weight-bearing exercise.
Your bones become stronger when they bear weight during exercise, and when some amount of impact or extra strain is placed on bones. Examples of weight-bearing exercise include dancing, yoga, walking, playing golf or tennis, and low impact aerobics. Do be careful, though, as too much strain could result in an injury.
Unfortunately, some risk factors are beyond your control and cannot be changed: your age, any family history of osteoporosis, your race or ethnicity, and being female.
Seek Help Early
Talk to your doctor about having a bone mineral density measurement test and possibly completing a FRAX ® assessment if you are concerned about osteoporosis. As the disease can progress with no symptoms until a bone fracture occurs, it’s a good idea to assess the risk factors and seek medical advice if you think you might be at risk of developing osteoporosis. If you have had a diagnosis of osteoporosis, consider our self-care tips to help you stay well and prevent fractures.
Advice + Support
Osteoporosis NZ was formed to raise awareness and knowledge of osteoporosis, to provide a national voice for people who have the disease, and to educate the public.
Its website has a wealth of information about osteoporosis, prevention, tips, treatment options, helpful links, and other advice. The site is worth a visit if you support someone who has osteoporosis or if you have developed the disease yourself.
Others may want to take the one minute test at the website after scanning our risk factors for osteoporosis. This simple test will flag whether it’s a good idea for you to talk to your doctor about osteoporosis.
Photo: Shutterstock.com, PhaitoonSutunyawatchai