What is osteoporosis and how to prevent serious fractures in old age

What is osteoporosis

Osteoporosis is a condition in which the strength of the bone tissue is compromised, resulting in fractures if there is minor injury. Normally, the bones of an adult maintain a balance between the work of osteoclasts - cells that destroy bone tissue - and osteoblasts - cells that form it. Violation of bone metabolism leads to accelerated loss of bone tissue, deterioration of bone quality, as a result of which its strength decreases and fragility increases. Under these conditions, a fall from even a low height can cause a serious fracture, immobility, and in the event of a hip fracture, death.

The fact is that conservative treatment, which is still very common in Russia, comes down to fixing the fracture area and bed rest. But the bones of an elderly person grow together very slowly, and the lack of movement for a long time leads to severe complications: bedsores, pneumonia, thromboembolism, and various infections.

Modern statistics show that osteoporosis ranks third after cardiovascular and oncological diseases among the causes of death in people over 45 years of age.

Who develops the disease

Osteoporosis is a disease that primarily affects the elderly. Since sex hormones play a very important role in bone health, this disease most often occurs in postmenopausal women - this type of osteoporosis is called postmenopausal.

Although men suffer from osteoporosis a little less often than women, it is a very common disease among them. It is found in every fifth man over 50 in the world and in every fourth. Such an unfavorable situation in our country is associated with the fact that men often have bad habits and suffer from a large number of severe concomitant diseases - these are additional risk factors for the development of osteoporosis. In addition, mortality after fractures in men is about 30% higher.

Osteoporosis is extremely rare in young people. As a rule, in this case, other diseases that affect the state of the bone tissue become the cause, and then the so-called secondary osteoporosis develops.

What affects the development of osteoporosis

Doctors can not always identify one cause that led to the disease. There can be many factors for the development of osteoporosis:

Presence of a previous low-energy fracture. This is the name of an injury that occurs when falling from a height of one's own growth and below, as well as when coughing, sneezing, and sudden movement. After each fracture that occurs, the risk of the subsequent one increases Osteoporosis - Incidence and burden by 2–3 times. Therefore, you need to be very careful about your bones and be monitored by a doctor in order to prevent new injury.
Genetic predisposition. If one of the parents had a hip fracture due to osteoporosis, then the person is at risk.
Low peak bone mass. At the age of 25-30, human bones reach their greatest strength. The higher the density and quality of bone tissue during this period, the lower the risk of developing osteoporosis in old age. Bone density can be calculated using a special examination called dual-energy X-ray absorptiometry.
Concomitant diseases that affect bone tissue. For example, diabetes mellitus, rheumatoid arthritis, insufficient function of the gonads (hypogonadism), cancer and genetic diseases, kidney disease.
Taking glucocorticoid hormones. Glucocorticoids are used to treat rheumatism, rheumatoid arthritis, bronchial asthma, acute lymphoblastic and myeloid leukemia, infectious mononucleosis, some skin and other diseases. Taking appropriate medications can cause glucocorticoid osteoporosis, one of the most severe forms of this disease. It can lead to a compression fracture of the vertebrae, which poses a danger to the spinal cord.
Bad habits. Alcohol and tobacco negatively affect the functioning of the whole body, including disrupting the process of bone metabolism.
Low weight. Body mass index less than 18 kg / m² is a factor in the development of osteoporosis. In addition, adherence to a strict diet, such as limiting protein intake or avoiding dairy products, can negatively affect bone health.
Calcium deficiency. With a lack of this substance in the body, parathyroid hormone is produced, which releases calcium from the bone, making it less dense.
Vitamin D deficiency. Vitamin D helps the body absorb calcium. It forms in the skin when exposed to sunlight. Since in northern latitudes the sun is inactive in winter, you can take vitamin D tablets or drops.

How osteoporosis is diagnosed and treated

The only clinical sign of osteoporosis is a low energy fracture. Depending on its severity, the traumatologist prescribes a certain type of treatment. Fracture of the femoral neck is considered one of the most dangerous consequences of osteoporosis and without surgical intervention leads to death in about half. femur and calculation of the average annual need for emergency surgical treatment. Traumatology and orthopedics in Russia, 2016 cases in Russia.

After successful treatment of the injury, the physician's task will be to restore bone mass. For this, today there are a number of drugs that increase bone density and significantly reduce the risk of fractures.

What measures are there to prevent osteoporosis?

The development of osteoporosis and the appearance of fractures can be avoided if you are concerned about the state of your bone tissue in advance. Your doctor may refer you for x-rays (densitometry) to assess bone density or laboratory tests to evaluate calcium-phosphorus metabolism and other important parameters.

In addition to timely referral to a specialist, there are other preventive measures:

physiotherapy;
a complete diet that satisfies the body's need for calcium, vitamin D and protein;
sun exposure, which ensures the production of vitamin D;
rejection of bad habits;
correction and control of concomitant diseases.

For self-assessment of the risk of fractures caused by osteoporosis, there is a FRAX calculator for calculating the 10-year risk of such injuries. However, it is worth remembering that this calculator cannot diagnose a disease, unlike a doctor.

In addition, there is a service on the website of the Russian Osteoporosis Association that will help you calculate whether you are getting enough calcium from your diet. Its deficiency can lead not only to osteoporosis, but also to other serious diseases.