Osteoporosis is one of several bone diseases that occur with more frequency in elderly patients. It may occur in both men and women, but it is more common and begins somewhat earlier in women.
Osteoporosis is a decline in bone mass, that is, in the total amount of bone substance. As the bones lose calcium and become less dense, they are more susceptible to fracture. Trauma is not necessarily required to cause a fracture in an osteoporotic bone. Fractures may occur with no more stress than is created during the usual activities of daily living. These bones, of course, are easily fractured when trauma does occur.
There are several types of osteoporosis. The most common is postmenopausal osteoporosis, which physicians call type I osteoporosis. Less common is senile osteoporosis, called type II osteoporosis by physicians. In addition, many diseases and drugs can cause osteoporosis, called secondary osteoporosis. Types I and II osteoporosis are diseases of aging.
At greatest risk for osteoporosis are white or Asian women who have had early menopause or have undergone surgical removal of the ovaries. Other risk factors include a family history of the disease, an inactive lifestyle, poor nutritional intake of calcium, deficiency of vitamin D, and smoking. Some kinds of prescription drugs may predispose patients to develop osteoporosis. Osteoporosis usually remains a completely asymptomatic process until a bone breaks.
Diagnosis of osteoporosis is often made at the time of an x-ray examination performed for another purpose. Calcium content causes bones to show up on x-ray film. Osteoporotic bones are less dense. Bony changes such as collapse of vertebrae or fractures also may be apparent on x-ray examination.
Important Points in Treatment
Prevention of osteoporosis is far better than treatment of the established disease. A program of selected exercise, calcium supplements, and, in some women, hormone replacement can prevent osteoporosis. The same approach can afford some benefits to already involved bones. In some types of osteoporosis, vitamin D may be used as well. Selection of the proper patients for hormone or vitamin D therapy depends on the nature of the osteoporosis and the occurrence of other problems or risk factors. It is a decision that your physician will make with you.
Fractures require specific management with splints, casts, bracing, and appropriate rehabilitation. The management selected depends on the nature of the fracture.
Notify Our Office If ...
- You have bone pain. Often the first indication of a broken bone in elderly patients is the sudden onset of bone pain.