BONE HEALTH IN AGING

We all know that bone health is one of the most neglected factors in our daily routine life, especially in older individuals. As one grows out of childhood, bones acquire bone mass, which gives strength to the bone. This continues till 30 years of age, after which there is continuous decline in bone strength and mass. In women, post-menopause (cessation of menstruation) there is sudden and rapid decline in bone mass, which lead to increased frequency of osteoporosis in them. However, after 70 years of age, both men and women are at equal risk of developing osteoporosis.

What are the reasons for osteoporosis?

There are few common causes that lead to osteoporosis:

1. Menopause is an important cause of osteoporosis. Due to loss of protective estrogens there is rapid bone loss and women with premature ovarian failure at young age develop it to a greater extent.

2. Inadequate intake of vitamin D and calcium. Studies have shown that vit. D deficiency is rampant in India and that leads to calcium loss and bone demineralization, as calcium is not available through meals

3. Lack of physical activity leads to decrease muscle bulk and increase bone Calcium loss. Hence, regular exercise schedule is must to prevent osteoporosis.

4. Smoking and alcohol intake are detrimental to bone health and lead to increase chances of fracture.

5. Other endocrine disease, bone related diseases and chronic medications like steroids may lead to decrease in bone mass and increase fracture risk.

How can it be diagnosed?

Osteoporosis might stay hidden have till there is a fracture. While vertebral fractures are common, patients may present with complain of backache, forward stooping of back or with more severe hip fracture, which increase risk of death in person and cause movement restriction. Hence, the recommendation that every woman more than 65 years of age and men more than 70 years of age should under go testing for osteoporosis using a DEXA Scan of hip and spine which may detect incidental fractures also.

What are the treatment options available?

Treatment is simple

• Adequate physical activity 
• Nutritious food rich in vitamin D and calcium  
• Lifestyle modification: Quitting smoking and alcohol is of utmost importance.
• Women with early menopause (before 40 years) should be treated with hormone replacement therapy to prevent bone loss in consultation with their treating expert.
• Medication: both oral and injectable forms are available. But drugs have their side effects and should be taken under supervision of endocrinologist.

Is it possible to prevent osteoporosis?

A healthy lifestyle, and regular intake of calcium and vitamin D starting from younger age group helps in achieving a good bone mass and prevention of osteoporosis.   

Dr Vineet Surana

MD, DM Endocrinology

Consultant Endocrinology

Metro Heart Institute and Hospital

Delhi.