"Osteoporosis" The silent threat that elderly people must be cautious of

Osteoporosis

“Bone” is an organ that constantly changes, with bone formation and resorption occurring throughout our lives. The amount of bone mass gradually decreases after the age of 30, especially in menopausal women whose bones break down rapidly. Dr. Pochong Chotiyanwong, an orthopedic surgeon specializing in geriatrics and metabolic bone diseases at the Musculoskeletal Institute, Phyathai 3 Hospital, states that osteoporosis is a “silent threat” that is frightening.

By the time you know you are sick, the bone is already broken

Dr. Pochong explains that this disease is scary because there are no warning symptoms. Patients usually find out only when complications occur, such as bone fractures from minor accidents like falling from a chair. People suspected of having this disease include those with decreased height, stooped posture, and muscle stiffness.

Who is at risk of osteoporosis?

The doctor divides the risk groups into 2 categories:

• Non-modifiable risk factors

1. 1. Age 65 years and older
   2. White women and Asian women
   3. Female gender
   4. Menopause or removal of both ovaries before age 45
   5. Small body build
   6. Direct relatives such as father, mother, sister, or brother with osteoporosis or fractures from minor trauma
   7. History of fractures from minor trauma (Fragility fracture)

• Modifiable risk factors

1. 1. Insufficient calcium intake
   2. Sedentary lifestyle
   3. Regular smoking
   4. Regular heavy alcohol or coffee consumption
   5. Body mass index less than 19 kg/m²
   6. Estrogen deficiency for more than 1 year
   7. Risk of falling, such as unsteady walking, impaired vision, regular use of sleeping pills, or taking blood pressure medication

How to diagnose if you have osteoporosis
Dr. Pochong explains that diagnosis can be made in 2 cases:

• In cases of fractures in the spine or hip from minor trauma such as falling on a flat surface, falling from a chair, or bed
• In cases diagnosed by a special X-ray machine, Dual-Energy X-ray Absorptiometry (DEXA), where the T-score is found to be > -2.5

How to treat to return to normal life

Treatment of osteoporosis aims to reduce the risk of further fractures, slow down bone resorption, and improve the patient’s quality of life. Dr. Pochong explains that treatment must be done in 4 aspects as follows:

• Eliminate modifiable risk factors such as regular exercise, eating nutritious food, and adequate calcium intake
• Identify diseases that may be risk factors for osteoporosis, such as hormonal disorders, gastrointestinal absorption problems, chronic obstructive pulmonary disease, or long-term use of certain medications
• Non-pharmacological treatment such as exercise, fall prevention, adapting living environments appropriately, and using suitable walking aids
• Pharmacological treatment with anti-osteoporosis drugs divided into two main groups: anti-resorptive drugs and bone-forming drugs to prevent fractures or reduce fracture risk, decrease bone resorption, and reduce pain from fractures

Therefore, if you find yourself at risk of osteoporosis, you should get properly diagnosed to receive timely treatment before complications occur. Having this disease significantly affects the quality of life of both patients and their close caregivers.