Osteoporosis is a systemic skeletal disease characterized by low bone density and resorption of bone tissue resulting in increased bone fragility. Osteoporosis can seriously affect the quality of life, including physical, social, and economic aspects. If left untreated, it can cause serious bone fractures that can be critical in old age. The risk of fractures is higher in elderly individuals with poor walking balance and vision.
WHO uses bone mineral density measurement (BMD) to define osteoporosis, according to which a T-score of less than or equal to -2.5 is considered osteoporosis.
Following are the causes of osteoporosis:
There are two types of osteoporosis, primary and secondary:
Osteoporosis can occur in all races and ethnicities; however, whites and Asians are at an increased risk. According to WHO, more than fifty percent of all hip fractures occur in Asia. Osteoporosis has a female to the male ratio of 4:1. Women of advanced age are more prone to non-traumatic hip fractures than men.Following are the risk factors for osteoporosis:
Clinical features do not appear unless the disease progresses to cause fractures, and even these fractures could be painless such as the vertebral fractures in which the only findings are stooped posture and height loss. Common signs and symptoms after a bone fracture include:
Complications of osteoporosis include:
Laboratory investigations include the following:
Differential diagnoses for osteoporosis include:
Pharmacologic intervention is recommended in all women with diagnosed osteoporosis who are at an increased risk of fractures and post-menopausal women. The drugs of choice in these groups are bisphosphonates and hormone therapies. Hormone therapies with estrogen and progesterone are done in postmenopausal women to replace these hormones as their loss is associated with increased resorption of bones.
Nonpharmacologic interventions are of prime importance to prevent fractures and other complications associated with osteoporosis. These include lifestyle modifications such as resistance training, exercise, weight loss, and dietary changes to improve vitamin D, calcium, and protein intake, promoting mineral deposition in bones and preventing resorption.
Surgical intervention is done in vertebral fractures, including vertebroplasty and kyphoplasty and hip replacement surgeries for hip fractures. Pain management uses oral analgesics, calcitonin, hot packs, electrical nerve stimulation, narcotic analgesics for severe pain.
If diagnosed early with proper intervention and compliance with the treatment, the prognosis is usually good. Fractures due to osteoporosis are associated with considerable morbidity and can affect the quality of life. With increasing age (more than 90 years), osteoporosis-related fractures are associated with increased mortality.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 25, 2023.
Osteoporosis | National Institute on Aging (nih.gov)
IJMS | Free Full-Text | Osteoporosis in Men: A Review of an Underestimated Bone Condition (mdpi.com)