Osteoporosis is a condition where bone mass decreases or becomes thinner with age, commonly found in postmenopausal women. The World Health Organization has set diagnostic criteria stating that individuals with a bone mass standard deviation compared to the general population of less than or equal to -2.5, as measured by DXA radiology, are considered to have osteoporosis. Generally, osteoporosis shows no symptoms. Those affected do not experience pain or abnormal joint characteristics. Therefore, osteoporosis is considered a “silent threat” that requires increasing caution as age advances.
Are you at risk of osteoporosis?
According to the clinical practice guidelines of the Osteoporosis Foundation of Thailand, the following individuals should undergo bone density testing to detect osteoporosis:
- Men aged 70 years and older
- Women aged 65 years and older
- Women who reached menopause at age 45 or younger
- Postmenopausal women with a body mass index below 20 kg/m²
- Postmenopausal women who have lost height by 4 cm or more
- Women aged 50 years and older with a history of fractures from falls
- Patients treated with steroids at a dose of 7.5 milligrams daily for 3 consecutive months
For women, sex hormones play an important role in maintaining bone mass. Postmenopausal women with decreased hormone levels are therefore at higher risk of osteoporosis than men.
If you have osteoporosis, do you need treatment?
Osteoporosis can cause disability in patients. Having reduced bone mass increases the risk of fractures, especially at the hip joint. Studies have found that the mortality rate of patients with osteoporotic hip fractures is as high as 20% within one year. Additionally, vertebral compression fractures from osteoporosis can cause spinal deformities, nerve compression, walking difficulties, and increased risk of falls, which may eventually lead to hip fractures.
Although some osteoporosis patients may not have fractures, the disease can complicate orthopedic surgeries such as knee or hip replacements in cases of osteoarthritis. Because the bones are thin and fragile, implanting prostheses increases the risk of fractures during surgery, leading to more complex procedures and potentially poorer outcomes.
Therefore, if you have osteoporosis, get treated! Treatment benefits include fracture prevention, reduced disability risk, improved bone quality, and lowered risk of other bone and joint surgeries.
Hip fractures: a serious threat in retirement age
Hip fractures are common and have a high mortality rate, especially in osteoporosis patients who are at increased risk of hip fractures from falls. All patients with hip fractures should undergo surgery because without it, they risk becoming bedridden, leading to complications such as pressure ulcers, urinary tract infections, respiratory infections, sepsis, and ultimately death.
Older adults and retirees are at high risk of hip fractures due to age-related osteoporosis and other comorbidities that increase fall risk, such as cataracts, middle ear diseases, hypertension, and diabetes. Therefore, treatment for this group should be comprehensive to address all related issues.
Wrist fractures: a warning sign of osteoporosis
Patients with wrist fractures from falls tend to be younger than those with hip fractures. However, studies show that patients with wrist fractures from falls have a higher chance of developing hip fractures from osteoporosis within the next 15 years. Currently, this group is often neglected and does not receive proper screening or education on fall prevention and osteoporosis risk reduction, leading to eventual hip fractures.
Treatment for wrist fractures can be surgical or non-surgical, but current studies show that surgical treatment results in better outcomes in terms of function, recovery, and quality of life.
Why do you get shorter as you age? A warning sign from the spine
Among elderly patients, spinal diseases significantly contribute to disability affecting movement and daily activities. It is common to see older adults become shorter and develop a hunched back due to spinal degeneration. Height loss may also result from vertebral compression fractures caused by osteoporosis. These spinal deformities disrupt body balance, increase fall risk, and make walking more difficult.
There is a misconception that bone degeneration, spinal curvature, and height loss are normal with aging. In reality, it is possible to maintain strong bones and normal posture even at an advanced age through proper health care and bone strengthening. Always consult a bone and joint specialist.
Step confidently, age healthily
Thailand is becoming an aging society in line with the global population’s average age. Life expectancy has increased due to advances in medical science that improve disease treatment. Therefore, older adults can maintain good health, move independently, and perform daily activities smoothly, enhancing their quality of life and happiness.
Besides bones, muscles and joints are also important for good health. Nutrients that benefit and strengthen both muscles and bones include vitamin D, which not only helps the body absorb calcium effectively but also maintains muscle mass, ensuring safe and stable steps as you age.
