Osteoporosis
Osteoporosis is a progressive skeletal disorder characterized by decreased bone mass and deterioration of bone microarchitecture, leading to increased bone fragility and a higher risk of fractures. It is considered a major public health issue worldwide, particularly in aging populations.
Often referred to as the “silent disease,” osteoporosis typically develops without symptoms until a fracture occurs — most commonly in the spine, hip, or wrist.
Bone is a dynamic tissue, constantly being broken down and rebuilt. In osteoporosis, the rate of bone resorption surpasses bone formation, resulting in weaker bones. This imbalance is influenced by factors such as hormonal changes (especially reduced estrogen in postmenopausal women), inadequate intake of calcium and vitamin D, sedentary lifestyle, and genetic predisposition.
Globally, 1 in 3 women and 1 in 5 men over the age of 50 will experience an osteoporotic fracture. These fractures are not only painful but can lead to significant disability, reduced quality of life, and increased mortality — particularly hip fractures in older adults.
Causes & Risk Factors
Osteoporosis is primarily caused by an imbalance between bone resorption and bone formation, often triggered by hormonal changes such as estrogen deficiency after menopause or age-related bone loss in older adults. Contributing factors include a sedentary lifestyle, smoking, excessive alcohol use, low dietary calcium and vitamin D, and chronic use of medications such as corticosteroids. Genetics and family history also play a significant role in an individual’s risk profile. While osteoporosis can affect anyone, women over the age of 50 and men over 70 are most commonly diagnosed.
Symptoms
Symptoms of osteoporosis often go unnoticed until a fracture occurs. However, as the disease progresses, individuals may experience back pain, a reduction in height, or a stooped posture due to spinal compression fractures. In severe cases, even mild trauma or daily activities can lead to broken bones, particularly in the hip, spine, or wrist.
Diagnosis
Diagnosis is typically confirmed through a bone mineral density (BMD) test known as a DEXA scan, which measures bone strength and calculates a T-score. A score of -2.5 or lower indicates osteoporosis. Additional tools such as the FRAX score help estimate the 10-year risk of major osteoporotic fractures and guide treatment decisions. Blood tests may also be used to evaluate calcium, vitamin D, and hormonal levels.
Treatment Options
Treatment involves a combination of medication, lifestyle adjustments, and nutritional support. Bisphosphonates are commonly prescribed to slow bone loss, while newer agents like denosumab and teriparatide may be used for more severe cases. Patients are advised to maintain adequate calcium and vitamin D intake and engage in weight-bearing and balance-focused exercises. Fall prevention strategies, such as home safety modifications and vision checks, are critical in reducing fracture risk.
Prevention Tips
Preventing osteoporosis starts early with proper nutrition, regular physical activity, and avoiding harmful habits like smoking and excessive alcohol. Postmenopausal women and older adults should undergo routine bone density screenings to detect early signs of bone thinning and begin timely intervention.