Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue. It causes bones to become weak and brittle so that a fall or even mild stresses like bending over or coughing can cause a fracture in the hip, wrist or spine. Fractures from osteoporosis are more common than heart attack, stroke and breast cancer combined. At least one in three women and one in five men will suffer from an osteoporotic fracture during their lifetime
A study on Osteoporosis in Asia shows that the incidence of hip fractures is estimated at 164 per 100,000 population for males and 442 per 100,000 for females. Also, the hip fracture rates have increased by 1.5 and 5 times for males and females respectively over the past 30 years.
Diagnosis of Osteoporosis
A normal X-ray can show osteoporosis of the bone because the thinning of the bone is visible as compared to normal bones. Unfortunately, by the time osteoporosis is detectable by X-ray, major part of the bone has already been lost. In addition, X-rays do not give a very accurate estimate of bone density.
Most of the major medical organizations recommend a dual-energy X-ray absorptiometry scan (DXA, formerly known as DEXA) be used for the diagnosis of osteoporosis. DXA typically measures bone density in the hip, the spine, and the forearm. The test takes only 5 to 15 minutes to perform, exposes patients to very little radiation (less than one-tenth to one-hundredth of the amount used on a standard chest X-ray), and is quite precise.
There are also some newer technologies available for diagnosis of osteoporosis like Peripheral DEXA, Quantitative ultrasound and bone turnover markers.
Management of Osteoporosis
Bone fractures caused Osteoporosis can be reduced by preventing bone loss or, preferably, by increasing bone density and strength. Although early detection and timely treatment can decrease the risk of future fractures, none of the available treatments for osteoporosis are complete cures as it is difficult to completely rebuild bone that has been weakened. However, it can be prevented through medication and by making some behavioral changes.
Medications stop bone loss and increase bone strength, such as alendronate (Fosamax), risedronate (Actonel), raloxifene (Evista), ibandronate (Boniva), calcitonin (Calcimar), zoledronate (Reclast), and denosumab (Prolia) along with teriparatide (Forteo) that increase bone formation.
PROTOS is a non-hormonal uncoupling agent that decreases bone desorption and increases bone formation. It is not a mineral supplement, but has a specific action on bone cells. It does not alter crystalline nature of the mineral portion of bone.
Lifestyle changes, including quitting cigarette smoking, curtailing excessive alcohol intake, exercising regularly and consuming a balanced diet with adequate calcium and vitamin D also lead to reduction in rate of reduction of bone density and increasing immunity.
Depression also causes the body to produce a stress-related hormone that saps minerals from bones. The right attitude and spirit may also the body to heal properly.Read about Management of Geriatric Syndromes
Care of the Older Person
About Our Doctor
Dr Sitoh Yih Yiow is a consultant geriatrician who graduated from the National University of Singapore in 1991. He obtained his Membership of the Royal College of Physicians of the United Kingdom in 1996 and was awarded a Higher Manpower Development Programme (HMDP) fellowship by the Ministry of Health... Read more about our doctor