What is osteoporosis?

Bone is a living tissue, constantly renewed through a natural process in which new bone replaces old bone. As we age, the process becomes less efficient and we begin to gradually lose bone. In someone with osteoporosis, bone loss occurs more rapidly, causing the bones to become very thin and weak over time.

When bones become severely weakened by osteoporosis, simple movements – such as bending over to pick up a heavy bag of groceries or sneezing forcefully – can lead to fracture. Wrist, spine and hip fractures are the most common fractures associated with osteoporosis.

Hip fractures related to osteoporosis are a serious problem in seniors, resulting in death in up to 20 percent of cases and disability in up to 50 percent of those who survive. Following a hip fracture, many seniors can no longer live independently, and may require nursing home care.

Who is at risk for Osteoporosis?

Women are especially at risk of osteoporosis because of the important role that the hormone estrogen plays in keeping their bones healthy. At menopause, estrogen levels fall dramatically, and many women experience an accelerated rate of bone loss.

Although men usually have a greater bone mass than women, they are not immune. As they age, they also lose bone mass and should follow the lifestyle changes recommended to prevent or delay osteoporosis.

Even though no single cause for osteoporosis has been identified, certain factors seem to play a role in the development of the disease. If you have some of these risk factors, you should speak to your doctor about getting a bone density test and take preventive action to reduce the risk.

It's possible to prevent, delay or reduce bone loss through healthy habits.

The risk factors for Osteoporosis

Some risk factors present a higher risk than others. They are indicated by *.

slender, small bones
low calcium diet
low physical activity
ovaries removed, or menopause before age 45*
past menopause
vitamin D deficiency
cigarette smoking
too much caffeine or alcohol intake
family history of osteoporosis*
excessive use of some medications (e.g. cortisone, prednisone, anticonvulsants)*
previous fracture*

How to Prevent Osteoporosis

Include calcium in your diet
Individuals over the age of 50 need 1000 to 1500 mg of calcium each day. As you age, your body doesn't absorb calcium as well, so it's very important to have calcium-rich foods in your diet. If you don't eat enough calcium-rich foods, you may require a calcium supplement.

Get enough vitamin D
Calcium is not easily absorbed by the body without vitamin D. Sunlight is the main source of natural vitamin D. Most seniors don't get enough of this vitamin, and a daily supplement of 400 to 800 IU may be recommended (especially in Canada where there's little sun intensity during the winter months).

Be active every day
Your bones react to increased activity by getting stronger. Regular weight-bearing activities such as dancing, walking, hiking and tennis are recommended. In addition, exercise that improves balance and coordination (tai chi, swimming and flexibility exercises) can help reduce falls and fractures. Keep experimenting until you find an activity that's right for you!

Avoid smoking
Smokers have faster rates of bone loss and a higher risk of fractures than non-smokers. Women smokers also tend to enter menopause at a slightly younger age than non-smokers. This causes the period of rapid bone loss to occur at an earlier age.

Treatment
In addition to adopting a bone healthy diet and lifestyle, some people may also require drug treatment to prevent or treat osteoporosis.

Hormone therapy
Hormone supplements replace the hormones that a woman's ovaries stop making at menopause. By reducing the drop in estrogen levels, these supplements can prevent or correct bone loss.

But estrogen is not always suitable. The decision to take or not to take estrogen should be made with your doctor, taking your individual circumstances into consideration. Bisphosphonates, selective estrogen receptor modulators (like raloxifene), or nasal calcitonin are other possible treatments that may be prescribed.