Flip through the latest issue of Gulf Weekly.
Osteoporosis, which means 'porous or spongy bones', is a condition that causes formerly strong bones to gradually thin and weaken, leaving them susceptible to fractures. It is often the subject of late diagnosis. Here Dr Wiam Hussein, consultant endocrinologist, explains the disease
This chronic, prevalent and possibly debilitating disease, presents a major public health concern in contemporary societies. It is the world's most common bone disease, affecting one out of three women and one out of five men over the age of 50.
The risk of suffering a fracture over the course of life is about 40 per cent for women, and 13 per cent for men. It may be higher in our part of the world due to more Vitamin D deficiency and lack of exercise and healthy eating habits.
Fractures at an older age can result in pain, loss of movement, inability to perform daily chores and may cause death.
The most common fractures associated with osteoporosis are those of the hip and the vertebrae.
With the predicted increase in the ageing population worldwide, the number of hip fractures could rise from 1.7 million in 1990 to 6.3 million by 2050. It is estimated that 71 per cent of these fractures will occur in developing countries including those in the Middle East and the Gulf.
Risk factors for developing osteoporosis: A number of factors increase the likelihood of developing osteoporosis and can be classified as 'modifiable' and 'non-modifiable'. Non-modifiable factors among women include female sex, ethnicity (white and Asian), advanced age, family history (fracture in first-degree relative), prior fracture in adulthood and poor health/dementia with frailty.
Emphasis should be placed on identifying modifiable risk factors. These include smoking, thinness (under 127 lb or under 60 Kg), early menopause (under 40 years of age, either natural or surgical), excessive alcohol intake, sedentary lifestyle, low calcium intake and poor general health.
Prolonged immobility due to paralysis or illness can also cause bone loss. Recurrent falls and poor eyesight increase the risk for subsequent fracture and should be addressed when assessing the patient.
Nulliparous women, those who have never had children, have higher rates of hip fracture than those women who have given birth. Pregnancy may induce biomechanical changes in the hip that later protect women from fracture.
The elderly are more prone to falls (impaired vision, dementia, physical frailty).
Diagnosis: A person is usually not aware they have osteoporosis until a fracture occurs. Backache, loss of height, with gradual curvature of the back (caused by vertebral compression fractures), may be the only physical sign of osteoporosis. An X-Ray examination of the spine may be obtained to confirm any suspicion.
In many affected people, bone loss is gradual and without warning signs until the disease is advanced. Osteoporosis is also known as 'the silent crippler' because a person usually doesn't know they have it until it's too late. Unfortunately, in many cases, the first real 'symptom' is a broken bone.
Several common methods can measure the bone density, the best method is DXA scan, which has been the most extensively validated method and is considered to be the 'gold standard' for assessing bone mineral density (BMD). This is because of its high precision, short scan time, and very low radiation dose.
A baseline DXA scan is needed to confirm the diagnosis of osteoporosis and for monitoring of the response to drug therapy. The test takes a few minutes and does not require any fasting or appointment scheduling but to keep your bones as healthy as possible take note of the modifiable factors listed above and take action now.
