Osteoporosis is incredibly common in older people. Australian research suggests that it may affect more than 50% of women over 80 years age and around one-fifth of men in the same age group. Many people with this condition are unaware that they are affected.
Why is osteoporosis a problem?
Osteoporosis makes your bones fragile and brittle, which increases their tendency to fracture – sometimes even in response to minor falls or injuries. Once you've had one osteoporotic fracture, you have a much greater risk of more fractures. While broken bones recover relatively easily when you’re young, as you get older they become more debilitating. For older people, hip fractures and other types of osteoporotic fractures often lead to reduced independence, mobility and quality of life.
What causes osteoporosis?
Bone is dynamic living tissue and undergoes a constant remodelling process in which it is continually broken down and re-formed. During the years that you’re growing, bone formation occurs more rapidly than remodelling. Once you've reached your peak bone mass, formation and bone breakdown occur equally and your bone mass stabilises.
However, by your mid 30s, the balance between bone building and bone breakdown activities starts to shift and you lose bone more quickly than you replace it. For women, this is increased by the decline in oestrogen that occurs during menopause. Over time, a condition known as osteopaenia occurs. This is where your bones lose density and become weaker and may progressively become osteoporotic.
Who’s most at risk?
Women are more likely to be affected by osteoporosis than men; however both sexes become increasingly vulnerable to low bone density as they get older.
Other factors that increase the risk of developing osteoporosis or experiencing an osteoporotic fracture include:
- Having a family history of osteoporosis.
- Having a low body weight or slender frame.
- Smoking.
- Having a high alcohol intake.
- Being physically inactive.
- Low oestrogen levels (women) or testosterone levels (men).
- Low levels of calcium, vitamin D or their co-factors.
- The incidence of osteoporosis is also increased among people who've been affected by certain health problems (e.g. rheumatoid arthritis and some endocrine disorders) and those who have taken certain prescribed medicines (such as corticosteroids)..
While some of these risk factors can’t be changed, there are a number of steps you can take to reduce your risk of osteoporosis, including stopping smoking, exercising regularly (with an emphasis on weight-bearing exercise) and avoiding excessive consumption of alcohol.
The importance of nutrition
Calcium plays a major structural role in the bones and it is the loss of calcium during the remodelling process that makes bones weak and brittle. Maintaining adequate calcium levels throughout life helps to build and maintain strong healthy bones, and may help to reduce the risk of osteoporosis. It’s also important to ensure you have adequate vitamin D, as it is needed for calcium absorption, and, in older people, may help to reduce the risk of falls and fractures.
Many people in Australia don’t get enough calcium or vitamin D, and may benefit from supplementation. You should also consider making sure you get enough magnesium, boron and other nutrients that support bone health.
