Runway Age Care: Osteoporosis

Osteoporosis is often referred to as the ‘silent disease’ because despite the fact that almost 3 million people in the UK are estimated to have osteoporosis, worryingly few people know they have it until they break a bone. There are more than 230,000 fractures every year due to osteoporosis.

What is osteoporosis?

Osteoporosis is a progressive condition that affects your bones as you get older. It makes bones fragile and more prone to break easily with the bones in your wrist, hip and spine being particularly susceptible.  

Why does it happen?

Bone is a living tissue with new bone replacing old bone throughout your life. In fact your whole skeleton is replaced over a period of around 7 years.

By your mid 20’s, your bones are at their strongest.  In your mid 30’s, they gradually start to become weaker and more fragile due to normal age-related bone loss - the special cells in your bones that build new bone cannot work as quickly as the cells that break down old bone. Bone loss becomes more rapid in women for several years following the menopause and can lead to osteoporosis and an increased risk of broken bones. The stronger your bones are when you reach your 30’s, the longer it will take for bone loss to lead to osteoporosis. 

Waiting until you break a bone is not the ideal way to detect osteoporosis. So if several of the above risk factors above apply to you, including a family member with osteoporosis or who broke their hip after a minor fall, discuss this with your GP. 

If you appear to be at high risk of breaking a bone or have broken a bone after a relatively minor fall, you may be sent for a bone density scan.
This is the most common way to diagnose osteoporosis and uses a machine, known as a DXA (Dual energy X-ray Absorptiometry) scanner.  To have a DXA scan you will need to wear loose clothing and lie on your back on a couch, while your hip and spine are scanned using low doses of radiation.  It takes about 10 - 20 minutes. Your bone density is compared with the average to produce a ‘T score’. A ‘T score’ of minus 2.5 standard deviations (SD) or less indicates osteoporosis.

Your scan results are looked at alongside other risk factors such as your age and family history. This helps decide if you are currently at a high risk of breaking a bone and whether drug treatment should be considered.

Before ordering a scan, your doctor may also use the World Health Organisation (WHO) FRAX® tool.  This calculates your risk, over the next 10 years, of breaking a bone in your hip or other bone such as wrist, upper arm or bone in your spine.  This tool can be used for women after the menopause and for men over 50. 

If you are at low risk, you are likely to be given advice about diet, exercise, drinking and smoking.  If your risk is high, then medication can be considered without the need for a bone scan.  If your risk is between low and high, a doctor may request a bone scan and then recalculate your risk of a broken bone and what steps can be taken to reduce your risk.

Treatments

There are now many treatments available for Osteoporosis. All medications have potential side effects whether they are for Osteoporosis or any another condition. When dealing with Osteoporosis, the risk of fracture usually far outweighs the risk of possible side effects. Please speak to your doctor and/or an Osteoporosis/bone specialist.

For more detailed information on treatments please contact the Irish Medicines board at:

Tel: 01 676 4971 Email: imb@imb.ie or www.imb.ie

Useful Links

www.irishosteoporosis.ie