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A Simple
Guide to
OsteoporosisJuly
2016

The word strikes fear in many people, because it is about weakened bones.

What is Osteoporosis?

This dreaded disease causes the bones to become brittle, especially those at the wrist, spine and hip. The bones become so brittle that even a simple fall, cough or stretch can cause a fracture.

Throughout our lives, our bones are alive and in a constant state of regeneration.

Old bone is broken down, and new bone is generated. This process happens at a faster pace when we are young – new bone is made faster than old bone is broken down, so our bone mass increases. We hit a bone mass peak sometime in our early 20s. Conversely, as we age, we lose old bone faster than new bone is generated.

The likelihood of developing osteoporosis depends partly on how much bone mass you attained in your youth. The higher your peak bone mass, the more bone you have ‘in the bank’ and the less likely you are to develop osteoporosis as you age.

Osteoporosis Myths

All you need is to drink milk and take calcium tablets and you will be OK

Fact

It is recommended that calcium comes from a combination of dairy products, dark green leafy vegetables, canned salmon or sardines with bones, soy products and calcium-fortified cereals and orange juice. This must include vitamin D that helps the body absorb calcium, along with exercise and precautions against falls.

There is no treatment as it is a natural part of ageing

Fact

It can be prevented with the right lifestyle habits in place from a young age, and can be treated if caught early enough.

Risk

There are risk factors which can be managed:

Hormones

Too much thyroid or too little sex hormones can lead to weakened bones and bone loss.

Dietary Issues

Low calcium intake, eating disorders and gastrointestinal surgery can result in weakened bones and osteoporosis.

Medication

Steroids and other long-term medications negatively affect the body’s bone-building process.

Lifestyle Choices

Lack of physical activity, alcohol intake and smoking contribute to osteoporosis.

Some risk factors are not modifiable:

  • Women are much more likely to develop osteoporosis than men
  • The older you are, the greater your chances
  • Having a parent or sibling with osteoporosis, especially if a parent experienced a hip fracture
  • Having a small body frame means you have less bone mass to draw from as you age

Symptoms

There are usually no symptoms in the early stages, but once bone loss has reached a significant level, the symptoms include:

  • Back pain
  • Loss of height over time
  • A stooped posture
  • A bone fracture that occurs much more easily than expected

How to prevent it

By taking simple but concerted steps:

  • Ensure adequate calcium intake, along with vitamin D, which helps the body absorb calcium
  • Doing regular strength training and weightbearing exercise to strengthen muscles and bones
  • Ensuring the home environment is fall-safe
  • Regular check-ups

Complications

Bone fractures, particularly in the spine or hip, are the most serious complication of osteoporosis.

Hip fractures often result from a fall and can result in disability and even death from post-operative complications, especially in older adults. Some 20% of hip fracture patients die in the first year and half lose their independence.

In some cases, spinal fractures can occur even if you haven’t fallen. The bones that make up your spine (vertebrate) can weaken to the point that they may crumple, which can result in back pain, lost height and a hunchedforward posture.

The likelihood of developing osteoporosis depends partly on how much bone mass you attained in your youth. The higher your peak bone mass, the more bone you have ‘in the bank’ and the less likely you are to develop osteoporosis as you age.

About Our Arthritis Specialist

A/Prof Leong Keng Hong is a senior consultant Rheumatologist at Gleneagles Medical Centre and Adjunct Associate Professor, Yong Yoo Lin School of Medicine, National University of Singapore. He founded the Osteoporosis Society (Singapore) in 1996 and served as its President until 2004. He was also the Inaugural Chairman of the Chapter of Rheumatologists, College of Physicians, Academy of Medicine, Singapore from 2004-2007 and its current Chairman until 2013.

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