Osteoporosis in Older People

Osteoporosis is a bone disease that affects the strength and thickness of bones, which makes the bones more fragile and is often not diagnosed until multiple fractures (broken bones) have occurred.

According to the Irish Osteoporosis Society the disease affects 300,000 people in Ireland.

Adequate vitamin D, calcium and weight-bearing exercise can help reduce the risk of fracture, but many patients require further medical management with a bone health specialist.

Osteoporosis in older people is more prevalent, and because it is estimated that of all EU countries Ireland is projected to have the greatest increase (117 per cent) in its elderly population (over 65 years) by 2035, the instances of the disease in Ireland is set to increase dramatically over that time.

There are many risk factors associated with Osteoporosis, the most common are as follows:

Genetic (Family History): Research shows that 80% of a person’s bone is influenced by genetics, especially in laying down the amount of bone during childhood.

 A broken bone due to a trip and fall in an adult: It is not normal at any age to break a bone from a trip and fall, from a standing position or less. Any adult who has broken a bone under these circumstances should be considered to have Osteoporosis, unless proven otherwise.

A broken bone due to a trip and fall in a child: As children’s bones are not fully developed, it is quite common for children to break bones. If a child does break a bone, it is important to find the cause/s and rule out Osteoporosis.

Upper, middle or low back pain If a person has upper, middle or low back pain, and they have risk factors for bone loss, a vertebral fracture (a broken bone in your back) should be ruled out. This can be done either by a DXA scan with an LVA (Lateral Vertebral Assessment) as part of a DXA scan, if this is available or by a plain lateral X-ray. The LVA should be done if the patient has lost height, postural changes, a hump has developed or has back pain.

Loss of height Loss of height is a sign that the person may have  fractured vertebrae (bone/s in spine). It should not be considered normal aging for a person to lose height as they age.

 Dowagers Hump on upper back: If it is due to Osteoporosis, the vertebrae in the spine are collapsing and unless treatment is initiated the person is at high risk for additional fractures within 6 to 12 months, which is known as the “Domino effect”. This also can place an older person at a high risk to fall, as their centre of gravity has changed, due their head/posture leaning forward.

 Past or present eating disorder: These include Anorexia, Bulimia, frequent dieting and/or over exercising.

Impaired mobility (bed bound or wheelchair) for 6 weeks or longer: When a person is non-weight bearing there are no stresses put on the bone, which is necessary for bones to stay strong and healthy, therefore bone loss occurs. If this happens during pre-puberty / teenage years it can significantly decrease the amount of bone laid down.

Multiple Sclerosis: If mobility (walking/weight bearing) is affected, bone may not be stimulated, and treatment is usually steroids, which causes bone loss.

Parkinson’s Disease: If mobility (walking/weight bearing) is affected, bone may not be stimulated, which can result in bone loss.

Underweight for your height This can place a person at a higher risk than those who are at a normal weight for their height.

 Not enough calories for amount of exercise If a person is not taking in enough calories to exercise, this will cause bone loss, usually due to low levels of sex hormone levels, which can also affect fertility.

 Physiological Stress Inadequate nutrition, poor absorption, excessive exercise, inadequate rest periods or excessive competitions can lead to physiological stress. This affects sex hormones, which can increase bone loss and may also lead to increased cortisol levels, which also cause bone loss.

The Irish Osteoporosis Society are the National Experts regarding Bone health. The Charity is dedicated to reducing the incidence of Osteoporosis and promoting good bone health. They provide information to the public and health professionals on all aspects of the disease. They also offer support to people with Osteoporosis, their families and everyone at risk from the disease.  The Society website can be found here: Irish Osteoporosis Society website



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