OSTEOPOROSIS

The definition of osteoporosis is centred on the level of bone mass, measured as BMD. For diagnostic purposes, two thresholds of BMD have been defined by the World Health Organization, on the basis of the relationship of fracture risk to BMD. The first threshold- defines the majority of individuals who will sustain a fracture in the future (osteoporosis), and The second a higher threshold more appropriate to the prevention of bone loss in women at the time of the menopause (low bone mass or osteopenia). Osteoporosis’ denotes a value for BMD or bone mineral content that is 2.5 standard deviations (SDs) or more below the young adult mean value (T-score less than –2.5). ‘Low bone mass’ means a T-score that lies between –1 and –2.5. ‘Severe’ or ‘established’ osteoporosis denotes osteoporosis as defined above in the presence of one or more documented fragility fractures.

Facts and figures : 

Facts and figures 1 in 3 women and 1 in 12 men in the UK will have osteoporosis over the age of 50 Every 3 minutes someone has a fracture due to osteoporosis An estimated 3 million people in the UK suffer from osteoporosis Each year the numbers of people with osteoporosis include over 70,000 hip fractures 50,000 wrist fractures 40,000 spinal fractures Osteoporosis costs the NHS and government over £1.7 billion each year, that's £5 million each day!

Risk factors: 

Risk factors For women: a lack of oestrogen, caused by early menopause (before age 45) early hysterectomy (before the age of 45), particularly when both ovaries are removed (oophorectomy) missing periods for six months or more (excluding pregnancy) as a result of over-exercising or over-dieting

Risk factors For men: low levels of the male hormone, testosterone (hypogonadism) For men and women: long-term use of high dose corticosteroid tablets (for conditions such as arthritis and asthma) close family history of osteoporosis (mother or father), particularly if your mother suffered a hip fracture other medical conditions such as Cushing's syndrome and liver and thyroid problems malabsorption problems (coeliac disease, Crohn's disease, gastric surgery) long-term immobility heavy drinking smoking

Diagnosis:  

Diagnosis normal x-ray of bone cannot reliably measure bone density but is useful to identify spinal factures, explains back pain, height loss or kyphosis. A bone density scan, called a dual energy x-ray absorptiometry (DXA) scan, is used to measure the density of bones and compare this to a normal range. This test is currently the most accurate and reliable means of assessing the strength of bones and your risk or fracture.

Treatments : 

Treatments For people who have been diagnosed with osteoporosis there are a range of treatments available. The most common treatments include: Bisphosphonates are non hormonal drugs, which help maintain bone density and reduce fracture rates. Calcium and vitamin D supplements can be of benefit for older people to reduce the risk of hip fracture. Hormone replacement therapy (HRT) is oestrogen replacement for women at the menopause, which help maintain bone density and reduce fracture rates for the duration of therapy. Selective Estrogen Receptor Modulators (SERMs) are drugs which act in a similar way to oestrogen on the bone, helping to maintain bone density and reduce fracture rates specifically at the spine. Testosterone therapy is testosterone placement for men with low testosterone levels to help maintain bone density.

Source: OSTEOPOROSIS IN ELDERS

by

Akshaya Srikanth

Pharm.D Internee

India