Osteoporosis in Seniors

Osteoporosis is a common condition that affects one in three women and one in five men over the age of 50 worldwide. It occurs when the body’s natural bone remodeling process is disrupted, and the bone tissue decreases at a faster rate than it can be replaced. This leads to weakened bones that are more prone to fractures, even with minimal trauma or stress.

Common Causes of Osteoporosis in Seniors

Several factors contribute to the development of osteoporosis, including:

Age and Gender: The risk of osteoporosis increases with age, and women are at a higher risk compared to men due to hormonal changes that occur after menopause.
Hormonal Changes: Lower levels of estrogen in postmenopausal women and reduced testosterone levels in men can accelerate bone loss.
Genetics: Family history plays a role in osteoporosis risk, as there is a genetic component to bone density and the susceptibility to fractures.
Ethnicity: Osteoporosis is more commonly seen in Caucasian and Asian populations compared to African American and Latino/ Hispanic populations.
Lifestyle Factors: A sedentary lifestyle, lack of exercise, poor nutrition, smoking, excessive alcohol consumption, and long-term use of certain medications (such as corticosteroids) can increase the risk of developing osteoporosis.
Excessive Alcohol Consumption: High consumption of alcohol negatively affects the ability of cells responsible for bone formation and impacts the hormone that regulates calcium metabolism.
Tobacco Use: There is a direct relationship between tobacco use and decreased bone density, however the exact cause is still unclear.
Decreased Levels of Nutritional Calcium and Vitamin D: If there is a not adequate intake of nutritional calcium, or if there is a lack of vitamin D to assist in absorbing calcium in the intestines, the body breaks down bone material to get the calcium it needs.
Lack of Physical Activity: A sedentary lifestyle can result in increased bone breakdown.

closeup of a woman holding the hands of an older man who has osteoporosis in seniors

Common Risk Factors for Osteoporosis

In addition, certain medical conditions or long-term use of some medications can increase the likelihood of developing osteoporosis. Common risk factors of osteoporosis include:

Hyperparathyroidism
Hyperthyroidism
Diabetes mellitus
Celiac disease
History of gastric bypass surgery
Chronic kidney disease
Rheumatoid arthritis
Systemic lupus erythematosus
Early menopause
History of previous bone fracture
Long term use of certain medications
- Oral corticosteroids
- Seizure medications
- Cancer medications that use hormones for the treatment of breast or prostate cancer
- Certain antidepressants

elder man sitting and holding his knee while feeling pain for senior osteoporosis

Signs and Symptoms of Osteoporosis

Osteoporosis does not have any overt symptoms and unless regular screening is performed, an individual may not be aware of the condition until a bone fracture occurs. However, as the condition progresses, the following symptoms of osteoporosis may become apparent:

Height loss or stooped posture (dowager’s hump) caused by the collapse of spinal vertebrae
Bone and back pain, often due to fractures or compression of the spine
Frequent fractures, particularly in the hip, spine, wrist, or other weight-bearing bones
Loss of bone density detected through a bone mineral density (BMD) test
Decreased mobility

It is crucial to consult a healthcare professional if there are any concerns about signs of osteoporosis or if there is a higher risk due to age, menopause, or other contributing factors.

How Can Osteoporosis be Diagnosed?

Early detection with screening in senior primary care is important to prevent the debilitating results of bone fractures. Screening begins with the use of an assessment tool to evaluate an individual’s risk for a bone fracture occurring. Screening is recommended to begin for all postmenopausal women at the age of 65, however for younger women with a high fracture risk profile, screening is typically recommended to begin at about 50 years. The prevalence of osteoporosis is lower among men and screening is determined on a case-by-case basis. It is generally recommended to begin osteoporosis screening in men beginning at the age of 70, especially in those with high risk factors.

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X-Ray

Diagnosis and screening is done by dual-energy X-ray absorptiometry (DXA) which is fast, convenient, and non-invasive. The test uses low radiation x ray scans to measure the bone mineral density in the hip and spine with the result expressed as a T-score which compares the of bone mineral density results to the normal healthy population. The T-score results are further classified as normal bone mineral density, osteopenia which is below normal bone mineral density and osteoporosis.

Lifestyle Modifications

Regular weight-bearing exercise, a balanced diet rich in calcium and vitamin D, limited alcohol consumption, and avoidance of smoking are essential for maintaining bone health.

Medications

Depending on the individual's needs and risk factors, a healthcare professional may recommend medications such as bisphosphonates which work by slowing down bone breakdown and loss, hormone therapy, selective estrogen receptor modulators (SERMs), or newer medications targeting bone resorption.

Fall Prevention

Reducing the risk of falls can help prevent fractures. This involves removing hazards in the home, improving balance and strength through exercise, and using assistive devices such as a cane or walker if necessary.

Calcium and Vitamin D Supplements

If dietary intake is inadequate, supplements may be prescribed to ensure proper bone health.

Senior Osteoporosis Treatment at Greater Good Health

A comprehensive approach that includes regular bone density assessments and consultations with healthcare professionals can help individuals maintain bone health and prevent complications associated with osteoporosis. At Greater Good Health, we offer preventive care and chronic condition management within our senior-focused primary care services. Contact us today to learn more and schedule your appointment.

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