Osteoporosis
is defined as a bone disease that is characterised by decreasing
bone mineral density
and bone mass, making bones weaker, leading to a decrease in bone strength, which in turn may increase the risk of fractures. Often, there are no visible symptoms till a fracture occurs, spurred by a minor fall or simply by bending. Paying attention to early signs of osteoporosis and taking a Bone Mineral Density (BMD) scan, can be critical in preventing mishaps and correcting the deterioration when there’s still time.
Osteoporosis thus leads to a higher risk of fractures, especially in the hip, spine, and wrist.
While this condition can affect men or women at any age, older women, especially those past menopause, are at a higher risk due to hormonal changes that accelerate bone loss. However, with the right combination of diet, medication, and physical activity, it is possible to slow down or even prevent further bone loss.
Understanding BMD Scanning
A Bone Mineral Density (BMD) test is a key diagnostic tool that measures the concentration of calcium and other important minerals in your bones. It not only helps in diagnosing osteoporosis but also in predicting the risk of future fractures and monitoring the progress of ongoing treatments.
The most common BMD test is a dual-energy x-ray absorptiometry (DEXA). This procedure is quick, non-invasive, and painless, using low-dose x-rays to measure bone density. It’s a simple procedure where the patient lies on a table while a scanner moves over the area being scanned. It measures the strength and thickness of bones, along with the composition of fat and muscle, helping doctors to make an assessment. While some patients may use a peripheral
DEXA
scan, which assesses bone density in the wrist or heel, it is less accurate in predicting fracture risk compared to the more comprehensive central DEXA.
Osteoporosis screening is particularly important for:
⦁ Women over the age of 65.
⦁ Younger women with risk factors such as a family history of osteoporosis, long-term use of certain medications like, oral contraceptives, steroids or lifestyle habits like smoking or excessive alcohol use.
⦁ Men over 70 or those who may have risk factors for low bone mass.
⦁ If there has been a significant loss of height in a year or sudden loss of weight.
⦁ Not getting enough calcium and vitamin D (dietary deficiencies or lack of exposure to sunlight)
When discussing osteoporosis with your healthcare provider, it's important to share any relevant information, including:
⦁ Past fractures and injuries.
⦁ Hormonal changes.
⦁ Lifestyle habits, including diet and exercise, alcohol consumption, and smoking.
⦁ Medical conditions and medications that may affect
bone health
.
⦁ Family history of osteoporosis or other bone-related conditions.
Your doctor may also conduct a physical examination to assess factors like muscle strength, balance, and changes in posture, which can indicate underlying bone loss.
Finally, a BMD test allows your doctor to:
⦁ Identify osteoporosis before serious damage occurs.
⦁ Evaluate the effectiveness of ongoing treatments.
⦁ Recommend tailored lifestyle changes and medication to reduce the risk of fractures.
If your BMD results indicate low bone density or osteoporosis, your doctor might suggest a range of treatments, from dietary changes and supplements to specific medications that help slow bone loss and strengthen existing bone tissue.
Treatment options to manage osteoporosis and slow bone loss include:
Calcium and Vitamin D: These are fundamental in maintaining bone strength. Calcium helps build and maintain bone tissue, while vitamin D aids in the absorption of calcium. Good sources of calcium include low-fat dairy products, leafy greens, and calcium-fortified foods. Vitamin D can be obtained from sunlight, as well as foods like egg yolks, fatty fish, and fortified cereals.
Lifestyle Changes: Avoiding smoking, limiting alcohol intake, and maintaining a healthy weight are all critical for bone health. Regular doctor visits and monitoring any changes in bone density can also help in managing the condition. Regular physical activity, especially weight-bearing and strength-training exercises, is vital for maintaining bone health. While exercise won’t significantly increase bone mass in older adults, it can improve muscle strength, balance, and coordination—reducing the risk of falls and fractures.
However, prevention is always better than a cure. A BMD screening allows healthcare providers to gauge risks early, prescribe appropriate treatments, and recommend lifestyle adjustments. By staying proactive about bone health—through diet, exercise, and regular screenings—it's possible to manage osteoporosis effectively and maintain a better quality of life as you age.
(Author: Dr. Saurabh Chandra, Consultant, Bone, Joint Replacement & Orthopaedics, SHALBY Sanar International Hospitals, Gurugram)