Opinion

Understanding osteoporosis

byAdam Johnson
6/20/2014

We are inclined to take our bones for granted. They provide the sturdy framework that is supposed to support us throughout life, barring any serious accidents. However, this framework is not as sturdy or unchanging as one may think. With age, we become more likely to experience broken bones due to surprisingly low-impact injuries. Simply bending over to pick something up can result in a broken vertebra. This increased susceptibility is due to a progressive loss of bone mass, a condition known as osteoporosis.

Throughout a person's life, bones go through a process called "remodeling," in which old bone tissue is lost and new tissue formed. During this normal process, special cells on the bone surface, called osteoclasts, dissolve old bone cells, leaving little holes. Other cells fill in these holes with new bone tissue. The shifting balance between bone growth and bone loss determines how our bodies grow and age.

The more calcium and exercise we get as children, the more bone mass we are likely to acquire. This growth period usually stops in our early twenties, at which point we reach what is known as "peak bone mass." As we get older, bone loss starts to outpace bone renewal. In some cases, this can lead to a severe decrease in bone mass. Lifelong deficiencies in calcium and vitamin D can come back to haunt us in our 50s, 60s, and beyond, as age-related bone loss leads to brittle, "porous bones" (this is the literal meaning of the term "osteoporosis").

Nearly 10 million Americans over the age of 50 have osteoporosis.

Postmenopausal women are at particularly high risk. After menopause, a decrease in estrogen often leads to reductions in bone mass. Some women lose up to 20 percent of their bone mass within the first five years after menopause. Other groups at risk include the senior population, people with smaller body frames, and people with a family history of osteoporosis. Risk factors include smoking, excessive alcohol intake, lack of calcium and vitamin D, and lack of physical exercise.

A person with osteoporosis might experience back pain, a reduction in height or stooping due to broken vertebrae. If you have experienced these symptoms, or if you have suffered a bone fracture due to a surprisingly minor impact, you should be tested for osteoporosis. Osteoporosis is often called a "silent disease," occurring with no warning signs and only making itself known after a bone fracture. Severe cases of osteoporosis can make bones so delicate that even sneezing or coughing might cause a fracture.

Preventing Osteoporosis

It's never too late to take preventative measures against osteoporosis.

Weight bearing exercises such as walking, running, or dancing are crucial for strengthening bones. Resistance exercises such as weight-training or swimming can also increase bone density. Maintaining good flexibility keeps joints limber and reduces the risk of breaking bones.

Be sure that you're getting enough calcium and Vitamin D. Your body uses calcium not just to replenish bone, but for many other purposes including muscle movement and cell-to-cell messaging. When you're not getting enough calcium through your diet, your body will start to draw its needed calcium from your bones, hastening bone loss. As you get older, the National Academy of Science recommends increasing your intake of calcium to 1200 milligrams daily. The most calcium-rich foods include milk, yogurt, cheese, leafy greens and calcium-enriched soy products like tofu and soymilk.

There appears to be a link between smoking and osteoporosis, as nicotine interferes with the body's ability to absorb calcium. Excessive alcohol intake has also been linked to osteoporosis.

Living with Osteoporosis

The same methods of preventing osteoporosis are also effective ways to cope with osteoporosis after you have been diagnosed.

It's important to do your best to prevent falls and seek treatment. Falling can have fatal consequences on a body weakened by bone loss. A doctor with specialization in osteoporosis can put you on a course of medication and bone-strengthening exercises regime to help slow bone loss, and in some cases reverse it.

Avoid smoking and excessive alcohol consumption, and be sure you're getting enough calcium and Vitamin D. Making sure your living space is well lit can help protect you from tripping. As vision and hearing play a role in maintaining balance, be sure to have an eye exam so you can stay on top of any issues that might be affecting vision. If you notice changes in your hearing, it could affect your balance so be sure to see an audiologist and address the issue promptly.

Adam Johnson writes for Youville Assisted Living Residences, member of Covenant Health Systems, a Catholic, multi-institutional health and elder care organization serving New England.