What is Osteoporosis?
Osteoporosis is a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. It occurs when the body loses too much bone, makes too little bone, or both. The bones become progressively porous, weak, and fragile, making them susceptible to fractures even from minor falls or bumps.
Understanding Bone Health
Bone is living tissue that constantly changes. Throughout life, old bone is removed (resorption) and new bone is formed (ossification). In youth, bone formation exceeds resorption. After about age 30, bone loss gradually outpaces bone formation, leading to a gradual decrease in bone mass.
Peak bone mass is reached around age 30. The higher your peak bone mass, the more bone you have "in the bank" and the less likely you are to develop osteoporosis later in life.
Risk Factors
Symptoms and Signs
Osteoporosis is often called a "silent disease" because bone loss occurs gradually and without symptoms until a fracture occurs. Warning signs may include:
- Loss of height: Progressive height loss over time
- Stooped posture: Developing a curved upper back (kyphosis)
- Back pain: Often from vertebral compression fractures
- Fractures: Breaking bones easily, especially hip, spine, or wrist
Diagnosis
Bone Density Testing (DEXA Scan)
The gold standard for diagnosing osteoporosis and assessing fracture risk:
| T-Score | Classification |
|---|---|
| β₯ -1.0 | Normal bone density |
| -1.0 to -2.5 | Osteopenia (low bone mass) |
| β€ -2.5 | Osteoporosis |
- DEXA (Dual-energy X-ray absorptiometry): Most accurate and widely used test
- Measures bone mineral density (BMD) at hip and spine
- Recommended for all women 65+, men 70+, and younger individuals with risk factors
Prevention and Management
Nutrition
- Calcium: 1,000-1,200 mg daily (through diet and/or supplements)
- Best sources: Dairy products, leafy greens, fortified foods
- Vitamin D: 600-800 IU daily
- Essential for calcium absorption
- Obtained from sunlight, fatty fish, fortified foods, supplements
- Protein: Adequate intake supports bone matrix
- Limit caffeine and sodium: Can increase calcium excretion
Exercise
Weight-bearing and muscle-strengthening exercises are essential:
- Weight-bearing activities: Walking, jogging, dancing, stair climbing
- Resistance training: Strength training with weights or resistance bands
- Balance exercises: Tai chi, yoga to prevent falls
- Frequency: At least 30 minutes most days of the week
Lifestyle Modifications
- Fall prevention: Remove home hazards, improve lighting, use assistive devices
- Quit smoking: Smoking accelerates bone loss
- Limit alcohol: No more than 1 drink per day for women, 2 for men
- Maintain healthy weight: Being underweight increases fracture risk
Medications
When indicated, several medications can help:
- Bisphosphonates: First-line treatment (alendronate, risedronate, zoledronic acid)
- Denosumab: Monoclonal antibody that slows bone loss
- Teriparatide/Romosozumab: Anabolic agents that build new bone
- Hormone therapy: Estrogen or related compounds for women
- Calcitonin: May reduce bone pain from fractures
Prevention is Key
Osteoporosis prevention should begin in childhood and continue throughout life. Building strong bones early and maintaining bone health can significantly reduce the risk of osteoporosis and fractures later in life.
References
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National Institute on Aging. (2023). Osteoporosis: Causes, Symptoms, and Management. Retrieved from https://www.nia.nih.gov/health/bone-health-and-osteoporosis
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International Osteoporosis Foundation. (2023). What is Osteoporosis? Retrieved from https://www.osteoporosis.foundation/patients/what-is-osteoporosis
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Cosman, F., et al. (2014). Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporosis International, 25(10), 2359-2381.
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National Health Service. (2023). Osteoporosis - Prevention. Retrieved from https://www.nhs.uk/conditions/osteoporosis/prevention/
5.δΈειͺ¨θ΄¨ηζΎειͺ¨ηΏηηΎη ζεΏ, (2023). εεζ§ιͺ¨θ΄¨ηζΎηθ―ηζε. https://doi.org/10.3969/j.issn.1674-2591.2023.05.001