Posted: November 17th, 2022

Osteoporosis in the Elderly

Osteoporosis in the Elderly
Osteoporosis can strike anyone at any age. However, as we age, our chances of developing this “silent disease” increase.

Osteoporosis is a major cause of broken bones in the elderly. Fractures can result in hospitalization, delayed healing, and the loss of independence. There are, however, precautions that can be taken to help prevent fractures and maintain a high quality of life.

The Elderly and Osteoporosis
What exactly is osteoporosis?
Osteoporosis is defined as “porous bone.”

Although all bones are porous, osteoporosis causes the pores to grow much larger than they should. As a result, they lose density and become more fragile than normal bones.

Osteoporosis is a common chronic disease that affects people as they age. It is often referred to as a “silent disease” because most people do not experience any symptoms of bone deterioration. That is, until an unexpected break or fracture occurs.

Fractures are serious osteoporosis complications in the elderly. As a result, avoiding them is critical in order to preserve the quality of life of older adults.

What factors contribute to osteoporosis?
Two things generally happen in the life cycle of bones:

Certain cells break down bone tissue to release minerals such as calcium.
Other cells are in charge of replacing the lost tissue.
As we get older, the ratio of breaking down to rebuilding shifts. As a result, more bone tissue is lost while less is rebuilt.

Without the minerals required to rebuild bone tissue, the bones soften. Unfortunately, this makes them more fragile and more easily broken.

Many factors can increase the likelihood of developing osteoporosis, including:

autoimmune conditions
gastrointestinal problems
hormonal imbalances
some medications, even during pregnancy
It is critical that older adults and/or their caregivers consult with their doctors. Also, inquire about any underlying conditions that may be contributing to bone loss. (1)

The Elderly and Osteoporosis
The Elderly and Osteoporosis
Osteoporosis-weakened bones are more likely to fracture than normal bones. As a result, sudden unexpected fractures in the elderly are usually caused by the development of osteoporosis.

These fractures can cause serious problems for the elderly. Unfortunately, bones that have already been weakened have a lower chance of fully recovering. This slow recovery can reduce one’s overall quality of life. It has the potential to cause long-term disability and loss of independence.

Who is in danger?
In the elderly, there are numerous risk factors for osteoporosis. Some are under your control, while others are not.

Osteoporosis Risk Factors
You have no control over the following risk factors for osteoporosis:

Age
After the age of 30, bone tissue breaks down faster than it is rebuilt. This results in bone density loss.
Sex
Women are more prone to osteoporosis.
After the age of 70, men are at a high risk of developing osteoporosis.
A family history of low bone density or osteoporosis may increase the risk of developing osteoporosis.
Other diagnoses include:
In some cases, osteoporosis caused by another health condition worsens if the underlying condition is not treated or managed.
Menopause
Because of hormonal changes during menopause, women are more likely to develop osteoporosis. The process of bone rebuilding includes the hormone estrogen. In addition, estrogen levels in women drop significantly after menopause.
Males with low testosterone levels
Although men do not experience rapid hormonal changes, low testosterone levels can lead to osteoporosis. More information on testosterone deficiency and osteoporosis can be found here.
Race
Women and men of all races are affected by osteoporosis. It is, however, most common in non-Hispanic white women and men.

medication, diet, and exercise
Controllable Osteoporosis Risk Factors
Other factors that increase the risk of developing osteoporosis are under your control. These are some examples:

Diet
A long-term diet low in protein, calcium, and vitamin D (all of which are essential for bone health!).
Sedentary way of life
Exercise is essential for the development of muscles and bones.
Alcohol
Long-term excessive drinking can impede bone reconstruction. As a result, bone density is decreasing.
Nicotine
Tobacco use can inhibit bone growth, putting people at risk for osteoporosis (2).
Signs and symptoms to look for in the elderly
Unfortunately, most elderly people show no physical signs of osteoporosis. However, fractures can occur unexpectedly. It is critical to recognize fracture symptoms as soon as possible.

Symptoms of spinal vertebral fractures (the back!) include:

severe back pain loss of height pain-related posture changes
Hip, wrist, and spinal vertebrae fractures are the most common osteoporosis-related fractures.

These are usually caused by minor falls or even simple movements like bending over or picking something up off the floor (3).

These fractures can significantly reduce the quality of life of older adults. Unfortunately, these fractures are extremely difficult to heal. They may exacerbate existing health problems. And they can be expensive!

Elderly Falls and Fractures Osteoporosis Statistics
In the United States, osteoporosis is a major public health concern. In 2010, approximately 10.2 million American men and women over the age of 50 were diagnosed with osteoporosis. Over 80% of those cases involved women (4).

Women are more likely than men to suffer fractures when they are younger. As a result, the rates of disability among older women skyrocket.

A study looked at the likelihood of repeat fractures in women. They discovered that 10% of people had another fracture within a year. Another 18% fractured again within two years. Finally, 31% experienced another fracture within 5 years (5).

Diagnosis and screening
According to research, women should begin screening for osteoporosis at the age of 65. If a woman under the age of 65 is at an increased risk of osteoporosis, she should be screened as her doctor recommends.

There are no established guidelines for when men should be screened for osteoporosis. However, it is generally recommended that patients report any fractures, family history, medical conditions, and so on to their doctors during annual checkups. A physical exam will also be performed by doctors to aid in the diagnosis of osteoporosis.

The bone mineral density (BMD) test is used to determine the density of bones in specific areas (usually the hips and the spine). This can aid in the accurate diagnosis of osteoporosis. And to keep track of how well treatments are working.

The dual energy x-ray absorptiometry test is the most commonly used to diagnose osteoporosis (DEXA). A T-score of -2.5 or less indicates osteoporosis-level bone density.

How can I deal with my osteoporosis?
It is possible to manage osteoporosis and increase bone density because the bones are constantly breaking down and rebuilding.

osteoporosis and calcium
Osteoporosis and calcium
Calcium is a mineral that is required for the human body to function properly. If we do not get this nutrient from food, our bodies will find a way to obtain it.

The majority of calcium (roughly 99%) is stored in bones and teeth. If the body does not get enough calcium from the diet, it will take calcium from the bones. Calcium is required for many bodily functions, including blood clotting and muscle contraction (6).

To protect the bones, it is critical to consume enough calcium through diet. Calcium supplements may be necessary for those who do not get enough calcium from their diet. Before beginning any supplements, consult with your doctor.

How Much Calcium Is Enough?
Calcium requirements differ between men and women.

Women:

50 years = 1,000 mg/day
Age 51 and up = 1,200 mg/day
Men:

70 years old = 1,000 mg/day
Age 71 and up = 1,200 mg/day
Calcium Food Sources
Calcium-rich foods to consider include:

Yogurt, milk, and cheese are examples of dairy products.
Orange juice (fortified with calcium and vitamin D) and cereals are two examples of fortified foods and beverages.
Almonds
Green turnip
Kale Bok Choi
Many commonly recommended calcium sources, such as spinach, collard greens, and sweet potatoes, are not included in the list above. This is because these foods contain oxalic acid, a compound that reduces calcium absorption.

Other options include calcium-fortified foods and beverages.

More information on calcium and calcium-rich foods can be found here.

Osteoporosis and vitamin D
Osteoporosis and Vitamin D
Calcium absorption is aided by vitamin D. A lack of vitamin D increases the risk of bone fractures and the development of osteoporosis.

Vitamin D can be obtained in three ways:

sunlight\sfood\ssupplements.
The skin can produce vitamin D from sunlight. The amount of vitamin D that the skin can produce varies with age, skin pigmentation, latitude, time of day, and so on. (6)

Other considerations include:

Growing Older
The ability of aging skin to produce vitamin D gradually declines.
Wearing SPF 8 sunscreen can reduce vitamin D production by 95%.
Skin cancer risk
Excessive sun exposure can significantly increase the risk of developing skin cancer.
Living in cities or institutions such as nursing homes
There is more time spent indoors.
How Much Vitamin D Is There?
The recommended amount of vitamin D is:

<50 years old: 600 IU daily
71+ years old: 800 IU daily
Research has shown that vitamin D supplementation can help decrease bone turnover and increase bone density. However, too much vitamin D can have adverse effects (7). (7).

Talk to a doctor or healthcare provider to assess your vitamin D level. And to suggest appropriate ways to fix a deficiency.

Food Sources of Vitamin D
Unfortunately, the availability of vitamin D in food is very limited. Fatty fish like salmon, tuna, and mackerel are good sources of vitamin D, as well as eggs and fortified foods such as milk, orange juice, soymilk, and cereals.

Check out this article for more information on Vitamin D in the Elderly.

Exercise and Osteoporosis
Resistance training and exercises like walking and jogging are helpful in building and strengthening muscle mass. Additionally, they can improve balance and coordination. Weight-bearing exercises are recommended for bone health and to help avoid fractures from falls.

By improving strength and coordination, older adults are able to move and fulfill daily activities with less risk of falling, as well as delay loss of independence(8) (8).

Physical therapists and rehabilitation specialists can help older adults develop a specific routine of exercises. Additionally, it is important to discuss exercise with your healthcare team.

Working with a Dietitian
Dietitians are able to provide nutrition education that is crucial in the management of osteoporosis. A dietitian can help in making healthy food choices. Similarly, they can help with choosing supplements to fill nutrition gaps.

Proper nutrition is crucial in the management of osteoporosis to prevent further bone loss and maintain the quality of life of older adults.

healthcare team
Working with Your Healthcare Team
If you have osteoporosis it is so important to work with your healthcare team.

Many healthcare providers work together to provide comprehensive treatments for osteoporosis (3). (3). These specialties include:

Endocrinologists
Gynecologists
Geriatricians
Occupational therapists
Physical therapists
Primary care provider
Registered dietitian
The team of healthcare providers work together to manage all aspects of osteoporosis treatment. For example, nutrition, medicine, physiological treatments, and more. The goal is to help those with osteoporosis to maintain the best quality of life possible.

Communication between the patient and the healthcare team is important to determine the best treatment option for each individual patient.

Preventing Elderly Falls and Fractures
Falls and fractures can result in additional medical complications and the loss of independence in older adults.

Staying physically active, limiting alcohol and tobacco use, and eating a calcium and vitamin D-rich diet are all critical for improving or maintaining bone and muscle strength and avoiding falls. (8)

Attempts to control the environment are another way to avoid falls and fractures. Physical and occupational therapists can help with fall prevention in the home.

Keeping the environment safe
To prevent falls, it is critical to maintain safe conditions both inside and outside the home.

Tips for avoiding falls at home:

Keeping rooms clutter-free and avoiding having multiple items on the floor.
Indoors, wear supportive, non-slip shoes.
To prevent slipping, use a rubber mat in the shower or tub.
Increasing the number of lights in the home, such as nightlights in bedrooms and ceiling fixtures to keep the stairs well-lit.
Being mindful of the placement of carpets and rugs.
Putting up handrails by the stairs.
Outside-of-the-home fall prevention tips:

Wearing shoes with good traction.
Avoid walking on slick or wet sidewalks.
For stability, I’m using a cane.
When walking outside, keep an eye out for curbs and steps. (9) Higher Quality of Life
Osteoporosis management Helps older adults in maintaining their independence and increasing their confidence.

The goal of osteoporosis management is to keep or even improve older adults’ quality of life. Similarly, to postpone disability and Help them in living the life they desire.

It is critical to seek treatment as soon as possible and to follow the advice of healthcare professionals.

Keep in touch with your healthcare team on a regular basis. Inquire about potential risk factors that may have an impact on bone health. Or increase the likelihood of falling.

Conclusion on Osteoporosis in the Elderly
Osteoporosis is fairly common in the elderly. It can also have a negative impact on one’s quality of life.

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