The body changes as we age, and it is often said that the bones become brittle and lose density with time. Is there any truth to it? On the occasion of World Osteoporosis Day today, Dr Sai Krishna B Naidu, HOD trauma and orthopedics, bone and joint surgery Fortis Hospital, Richmond Road, Bengaluru answered some frequently-asked questions, including if human beings begin to lose height as they make progress in age.
Explaining what osteoporosis is, the doctor said it causes the bones to become weak or brittle because of loss of mass and density. “More than 1 crore people in India suffer from it. Initially, these patients do not exhibit any symptoms, but gradually, they develop back pain and loss of height.”
Why do we lose height? Dr Sai Krishna explained it happens partially due to “disc dehydration”, causing the collapse of the spine. “Also in severe osteoporosis, the vertebral fracture at multilevel can cause the significant collapse in height.”
Who is at risk?
According to the doctor, it is a common occurrence in the elderly population and in post-menopausal women. “Sedentary workers like IT professionals, office goers, and children who are mostly indoors are at increased risk of ‘osteopenia’. This is due to lack of sunlight exposure, vitamin D deficiency, along with inactivity,” he said.
Dr Sai Krishna added that “bone remodelling” happens with activity, which is why it is good to to walk an average of 5,000 to 6,000 steps a day. “Certain medical conditions like Systemic lupus erythematosus (SLE), patients with rheumatoid arthritis, transplant, etc., are on corticosteroids — these treatments pose a high risk of osteoporosis.”
What is the difference between osteoporosis and osteopenia?
“Osteopenia occurs in the younger population with lack of activity, and is a milder form. Also, nutritional deficiency (of calcium and vitamin D) can lead to it. It can be differentiated by certain tests,” the expert said.
The doctor said one must walk and do exercises, besides being exposed to sunlight and eating a healthy nutritional diet rich in calcium and vitamin D. “Get regular checkups with your doctor if you are in the post-menopausal group.”
“Treatment is based on the diagnosis of the condition and associated medical issues.”
* Supplements of vitamin D and calcium as recommended in younger populations.
* Bisphosphonates such as alendronate, zoledronic acid, etc., for both men and women at the high-risk stage.
* Post-menopausal women will need hormone replacement therapy, along with roloxifene; in elderly men, osteoporosis is due to decline in testosterone levels.
* Certain bone-building medications — teriparatide, abaloparatide, etc., can reduce the risk by reducing the “osteoclastic activity” in bone.