Introduction-
Osteoporosis is defined as low bone mineral density caused by altered bone structure and may lead to fragile bones, thus causing fractures. In 2004, the WHO defined it as a “BMD that lies 2.5 standard deviations or more below the average value for young healthy women. This is applicable for postmenopausal women and also for men above 50 years of age. It is a chronic and progressive disease involving a multifactorial etiology.
Osteoporotic fractures, thus lead to a significant decreased quality of life.
Etiology
Bone tissue is constantly being absorbed and replaced therefore Bone mass decreases when the rate of absorption exceeds the rate of production. This typically occurs with advanced age.
Types of osteoporosis –
- Primary
- Secondary
Primary osteoporosis
Primary osteoporosis has no known cause, but there are many contributing factors to etiology which include prolonged negative calcium balance, impaired adrenal function, oestrogen deficiency, or sedentary lifestyle.
Types of primary osteoporosis:
- Postmenopausal osteoporosis
- Senile
- Idiopathic juvenile osteoporosis
Secondary osteoporosis-
- It is caused by prolonged use of medications or secondary to another condition
- Low calcium intake or absorption
- Excessive alcohol consumption
- Sedentary lifestyle.
- Hormonal imbalance and dysfunction with thyroid, parathyroid, or adrenal glands.
Risk factors for developing osteoporosis
- Advanced age (≥50 years)
- Females
- family history of osteoporosis
- Amenorrhea
- Late menarche
- Early menopause
- Postmenopausal phase
- Physical inactivity/ sedentary lifestyle/ immobilisation
- Use of anticonvulsants, systemic steroids, thyroid supplements, heparin, chemotherapeutic agents, insulin.
- Alcohol and tobacco use
- Androgen or estrogen deficiency
- Calcium or vitamin D deficiency
Clinical features seen-
Until osteoporosis is quite advanced, loss of height and kyphosis is evident.
Clinical Signs and Symptoms
- Compression fracture of the spine
- Bone fractures
- Decrease in height
- kyphosis
- Dowager’s hump
- Decreased activity tolerance
- back pain in thoracic or lumbar region
Prevention-
- screen women at the age of 65 years and men at the age of 70
- Patients with risk factors should be screened sooner
Exercising with osteoporosis-
- Weight-bearing exercises
- Exercises such as walking or hopping.
- Strengthening exercises, using weights or resistance band
- Flexibility exercise
- Stretching and yoga
- Postural exercise
- extension exercises such as chin tucks, scapular retractions, thoracic extensions.
- avoid flexion exercises
- balance training
lifestyle modifications-
- Follow a healthy diet that inclusive of calcium and Vitamin D
- well-fitting shoes to avoid falls
- Avoid rugs and sloppy slippers
- Try to avoid heavy lifting
Dietary Management
The most important nutrients are intake of calcium and vitamin D.
- recommended intake is 1000–1200 mg/day of elemental calcium for older adults
- Eating foods that contain vitamin D
- Sensible sun exposure
- Taking a vitamin D supplement
- recommended intake is 700–800 IU/day for older adults
Also read- https://vcurehealthcare.com/understanding-bmi-body-mass-index/
