Osteoporosis is the most common bone disease in humans, representing a major public health problem. Osteoporosis is a silent disease until it is complicated by fractures that occur following minimal trauma. Fractures are most common at spine and hip and place an enormous medical and personal burden on the ageing individuals who suffer them.
It is characterized by low bone mass, deterioration of bone tissue and architecture, compromised bone strength and an increase in the risk of fracture. Osteoporosis is defined by Bone Mineral Density (BMD) at the hip or lumbar spine. It is a risk factor for fracture just as hypertension is for stroke. The risk of fractures is highest in those with the lowest BMD.
Osteoporosis can be prevented, diagnosed and treated before fractures occur if these instructions are followed:
- A diet that includes adequate amounts of total calcium intake (1,000-1,200 mg per day), incorporating dietary supplements if diet is insufficient.
- Vitamin D intake (800-1,000 IU per day), including supplements if necessary for individuals age 50 and older.
- Regular weight-bearing and muscle-strengthening exercise to improve bone strength; and reduce the risk of falls and fractures.
- Cessation of tobacco smoking and avoidance of alcohol intake.
- Measure height annually (the decrease in height of 2-3 cm is likely due to vertebral fracture)
BMD testing should be performed:
- In all women age 65 and older and men age 70 and older.
- In postmenopausal women and men above age 50-69, based on risk factor profile.
Pharmacologic treatment should be started:
- In those with hip or vertebral fractures.
- In those with T-scores < -2.5
- In postmenopausal women and men age 50 and older with low bone mass (T-score between -1.0 and -2.5, osteopenia) with risk factors.
Dr. Aleksandar Dimic
(Rheumatology and Internal Medicine Consultant)
Bahrain Specialist Hospital