Osteoporosis, literally meaning “porous bone,” is a disease that affects millions of aging Americans. About 10 million Americans struggle with osteoporosis, while another 44 million have low bone density that puts them at risk for developing the disease. This condition can have a dramatic effect on the way you or a loved one live your lives, so it’s crucial to find out more about the causes, symptoms, prevention and management of osteoporosis in elderly people.
What Is Osteoporosis?
Osteoporosis is a disease of the bone. We tend to think of bones as being solid, but they consist of living tissue. That tissue is mostly the protein collagen, which provides a soft, flexible framework, in addition to calcium phosphate, which provides structural strength and hardness. When bones are healthy, they have a surprising amount of flexibility that helps absorb impact.
When we’re growing up and through our late 20s, our bodies add new bone faster than they remove old bone. That’s how our bones get larger and denser. However, starting in our 30s, resorption of bone starts to surpass the pace of new bone formation. When bone formation occurs too slowly or bone loss happens too quickly, osteoporosis develops.
Risk Factors for Osteoporosis
There are a variety of risk factors for osteoporosis that no one can change. These factors include the following.
- Sex: Women are at significantly higher risk for osteoporosis. About half of women over age 50 will experience one or more bone breaks due to the condition.
- Age: Why is osteoporosis more common in elderly people? Bone loss continues to increase and bones get weaker with age.
- Body type: The smaller and thinner your bones are naturally, the more quickly bone loss and risk of fracture increase.
- Ethnicity: White and Asian women have the highest risk, while African American and Hispanic women have a lower but still significant risk.
- Family history: There appears to be a hereditary element to osteoporosis, as those whose parents have a history of fractures also have reduced bone density and increased risk of fracture.
Having one or more of these osteoporosis causes results in a compounded risk, increasing the need for monitoring and prevention efforts.
How Osteoporosis Affects You as You Age
Many people think of osteoporosis as a “silent disease” because there are typically no outward symptoms to catch. It is unfortunately common for people to have significant age-related bone loss and not know it until they fall and break something. As you age, pay attention to osteoporosis symptoms like:
- Sudden back pain
- Increased stooping in posture
- Loss of height
Older women need to be proactive about screening for osteoporosis, due to their significantly heightened risk for the condition. Medical experts recommend all women over 65 undergo bone density tests regularly. Men over 70 or who are at high risk for bone loss should also consider screenings for osteoporosis.
While osteoporosis is not painful in and of itself, it may lead to bone breaks or fractures that do cause pain. If you know you have osteoporosis, it will affect specific elements of your life, such as the types of exercise you can safely do.
Screening for Osteoporosis
Osteoporosis screenings involve a bone densitometry test, called a DXA or DEXA scan. It measures your bone mineral density (BMD). The person conducting your scan compares the outcome to the average BMD of a typical adult of your ethnicity and sex around ages 25 to 30 — the age of peak bone mass. Your result is a “T score.”
- T scores -1 to +1 indicate normal bone density.
- T scores -1 to -2.5 indicate low bone density, also called osteopenia.
- T scores -2.5 or lower indicate bone density that’s low enough to diagnose osteoporosis.
Every full-point drop past 0 doubles your risk of incurring a fracture. Some physicians use DXA results to create an estimate of your risk for hip fractures and any other type of fracture for the next 10 years. Does bone density decrease with age? Yes, but your doctor will be able to alert you when regular bone loss escalates into a diagnosis of osteoporosis.
If your doctor finds you have the condition, there are five main types of osteoporosis treatment.
This medication comes in a daily nasal spray. It can reduce the risk of spinal fractures by 25%, but may not lower risk for other types of fractures. On the other hand, it is very well-tolerated and produces few side effects.
This daily medication comes in pill form and has demonstrated a 30% fracture reduction. It works by either blocking or stimulating the action of estrogen, depending on the tissue type. It can also reduce the risk of breast cancer. However, because it modulates estrogen activity, it can cause hormone-related issues like hot flashes and can also slightly raise the risk of blood clots.
Doctors can administer these medications in a once-a-day pill or an intravenous infusion once per year. They can lower the risk of spinal fracture by 50% to 60%, and reduce hip fracture risk by 50%. It is common for doctors to prescribe the use of this medication for several years at a time, with pauses for one or more years as necessary. The initial infusion can come with severe side effects like upper gastrointestinal issues and flu-like symptoms.
This medication is a subcutaneous injection received two times per year. It has the same risk reduction rates as bisphosphonates but has fewer side effects.
5. Parathyroid Hormone
This once-a-day subcutaneous injection reduces spinal fracture risk by 65% and other fracture risks by 53%. It works by stimulating bone growth instead of slowing down bone loss. Currently, patients can only use it for two years at a time.
How to Prevent Osteoporosis
Is osteoporosis a normal part of aging? It doesn’t have to be. While aging and bone loss do go hand in hand, there is a lot you can do to prevent it from escalating to osteoporosis. The following factors can reduce your risk of developing this condition.
1. Calcium Intake
Calcium supply across a lifetime affects the risk of osteoporosis. Lower calcium intake results in lower bone mass, in addition to more rapid bone loss. Many people receive less than half the calcium they need to build and sustain bones. Men 51 to 70 years old need 1,000 milligrams of calcium per day, and women in the same age range need 1,200 milligrams daily. Food sources of calcium are the best intake option, and you can get the most calcium from:
- Dark green, leafy vegetables
- Sardines and salmon with bones
- Low-fat dairy products
- Calcium-fortified foods
It may be a good idea to ask your doctor about a calcium supplement if you can’t get enough of it from your diet alone.
2. Vitamin D
Your body needs an adequate supply of vitamin D to absorb calcium and keep your bones healthy. A lot of people get enough vitamin D through sun exposure and foods such as egg yolks, liver and saltwater fish. However, older adults have decreased vitamin D production. Up to age 70, 600 international units (IU) of vitamin D daily is sufficient. After age 70, intake should increase to 800 IU per day.
Bone is living tissue, just like muscle. That means it becomes stronger through exercise. It’s essential to consider the type of exercise undertaken, as high-impact exercises like jogging are more likely to result in stress fractures or other types of fracture. The safest options for bones are resistance and weight-bearing exercises such as:
- Walking and hiking
- Weight training
Some health experts believe yoga is an effective way to maintain bone health. For older adults with bone loss who can only participate in a limited range of physical activity options, the lack of impact is a valuable feature. Yoga may also help retain core strength and flexibility, both of which are more difficult to maintain for older people.
Most people know smoking is bad for your lungs and heart, but it can lead to poor bone health as well. Women who smoke produce less estrogen and may go through menopause earlier, precipitating early bone loss. Smoking also interferes with the absorption of calcium, reducing a person’s ability to keep up with calcium intake needs.
Regularly consuming only two to three ounces of alcohol per day can damage the skeletal system, regardless of age. In addition to worsening bone loss, heavy drinking increases the risk that someone will fall and experience a fracture due to intoxication. People who misuse alcohol are also less likely to follow a balanced diet with enough nutrients to maintain bone health.
How to Care for Someone With Osteoporosis
Whether you have osteoporosis yourself, or you are caring for someone else with the condition, managing the disease is crucial in preventing injury. Here are four things you can do to care for someone with osteoporosis.
1. Confirm Regular Treatment
First, ensure the person with osteoporosis is regularly receiving quality medical care. As a degenerative condition, osteoporosis can dramatically worsen without proper monitoring and treatment. The individual with the disease should thoroughly explore all their options with their physician or orthopedic doctor.
Regular bone density scans will help the provider evaluate the progression of the disease and determine whether the selected treatment is working effectively.
2. Evaluate the Home Environment
Bone loss makes even mundane activities around the house more dangerous. Stairs, for example, increase the chance that someone with osteoporosis will fall and break a bone. While a full flight increases the risk further, even something as small as a step down into the living room can be dangerous.
Part of fall prevention entails eliminating unnecessary heights that require the person to use a stool to reach household items. For example, moving dishes from the top shelf to the bottom shelf of a cabinet can keep a person from having to use a stepstool more often than necessary. Address anything that increases instability or inhibits balance as well. If the home has wood floors, it may be prudent to switch to carpet flooring, or at least provide floor runners with rubber grip to the main pathways in the home.
Inspect the home to see what accessibility features you can install and what dangers you can remove.
3. Develop a Nutrition Plan
Many people struggle with achieving a balanced diet, and it gets harder as aging decreases energy and strength. It’s a good idea to sit down and create realistic meal plans for the person in question, so nutrition does not become a source of stress.
The nutrients essential to bone health include:
- Vitamin D
- Vitamin A
Creating a diet rich in these nutrients can help maintain bone health and slow age-related bone loss. Consulting a nutritionist is advisable.
4. Consider In-Home Care
Living with osteoporosis increases the chances that an older adult will fall and sustain a life-threatening injury, even with safety measures in place. The more activities a person has to do for themselves — like cooking, cleaning and grocery shopping — the more likely they are to have an accident. Personal care services provide peace of mind for older adults and their loved ones by assisting with:
- Grocery shopping
- Meal preparation
- Light housekeeping
- Transportation for errands and medical appointments
- Bathing and personal hygiene
- Dressing and grooming
- Dental hygiene
- Fall prevention
Eldercare professionals can also provide much-needed companionship for older adults whose osteoporosis affects their ability to socialize outside the home.
If you are currently caring for someone with osteoporosis, you already understand the need for frequent check-ins. You may also have noticed an escalation in the needs of the individual. For instance, your loved one who previously only needed help with cooking may now need help getting the groceries and doing clean-up afterward.
For most people with demanding lives and families of their own, being a personal caregiver for someone with osteoporosis eventually becomes unsustainable. Considering a high-quality in-home senior care service is a good idea, even if the person is currently able to function well.
Active Home Care for Osteoporosis
Aging and bone loss can create a significant amount of stress for older adults and their loved ones. Managing osteoporosis often means giving up at least some degree of independence, and the need for assistance only increases as the individual gets older. If you or someone you love has received a diagnosis of osteoporosis, it’s time to start looking to the future and considering the type of care needed.
Active Home Care is a provider of compassionate home care for families in Florida. Our senior care services allow older adults to enjoy the comfort of their homes while receiving assistance from professional caregivers. If you have questions about our services or would like to schedule a free home visit in Florida, call Active Home Care at 786-360-3449. You can also fill out our online contact form to get in touch.