Osteoporosis literally means porous bones. When the bones become thinner, they become more fragile resulting in a higher risk of fracture.

Normal Bone

The skeleton is constantly changing, and the components of bone is replaced and rebuilt in order to adapt to the stress of living. Each bone is completely remodelled over a period of 12 months.

The effect of age and illness on normal bone

As we age there is a decline in bone strength and the greatest risk for an osteoporotic fracture is increasing age.

 

 

 

 

 

Any illness that contributes to increasing the rate of ageing leads to an increase in the rate of osteoporosis and the risk of a fracture.

A common factor in all ageing diseases is inflammation. These diseases include

  • autoimmune diseases eg rheumatoid arthritis.
  • neurodegenerative diseases eg Parkinson’s Disease
  • diabetes
  •  cancer

Other causes for accelerated osteoporosis

Lifestyle factors

Lack of exercise throughout life. 15% of bone strength is related to muscle mass. The more muscle the better.

Nutritional deficiencies such as low calcium intake. 5% of bone strength is due to nutrition.

Low vitamin D leads to poor absorption of calcium

Smoking

Low body weight.

Genetics

Bone strength is dependent on bone size. 80% of bone strength is genetic.

Hormones

Low oestrogen in women and low testosterone in men can cause osteoporosis

Medications

The most common ones are:

corticosteroids

antiseizure medications

aromatase inhibitors

Fractures

fractureA fracture leads to a profound negative impact on the quality of life, health span and lifespan.
An osteoporotic fracture is a life-changing event. This fact is very relevant when weighing up the benefits and risks of any therapy.

Most of the vertebral fractures are asymptomatic and therefore under-diagnosed.

A fracture leads to a profound negative impact on the quality of life, health span and lifespan. An osteoporotic fracture is a life-changing event. This fact is very relevant when weighing up the benefits and risks of any therapy.

One person in 5 will have one or more osteoporotic  vertebral fracture after the age of 50. Most of the vertebral fractures are asymptomatic and therefore under-diagnosed.

Preventing a fracture is the best solution and the goal in managing osteoporosis.

How to determine the risk of a fracture?

If a patient has a decreased bone mineral density and/or risk factors for rapid bone loss, the bone mineral density should be monitored  annually. Examples of risk factors include

A perimenopausal state
Use of glucocorticoids
Use of aromatase inhibitors
Low body weight
Malabsorption.

For any given bone density as measured by a DEXA Scan, the “t- score”, which is an estimate of the risk of fracture increases with advancing age and risk factors.

The articles below are designed to increase awareness and knowledge of osteoporosis so that appropriate treatment is initiated in those with the highest risk for fracture. The primary aim is to prevent a fracture.