2 What is it ? Often known as the Silent thief Osteoporosis is a disease in which bones become fragile and are more likely to breakCharacterized by a decrease in mass resulting in bones that are more porous and easily fractured.These broken bones also termed fractures usually happen in the wrist, spine, and hips
3 Two types of osteoporosis First type is termed type 1 which affect 5-20 % of women. This is the type associated with menopause as low estrogen levels cause a decrease in the amount of calcium absorbed. This type is characterized by vertebral fractures of the spine.Second type is called type two with this type the process of re-absorption and formation of bone are no longer coordinated meaning your osteoblast and osteoclast cells are not balanced leading to a state where bone breakdown overcomes bone building. This type happens in both men and women.
4 Who This Disease Effects It affects both males and females age 35 on. But Effects more women than men as women have less bone mass compared to menEspecially seems to effect post menopausal womenAt age 75 both sexes become equally prone for bone loss
5 Statistics 1.4 million Canadians suffer from the disease 1 in 4 women over the age of 50 has osteoporosis. Higher in women because we have less bone mass and live longer.1 in 8 men over the age of 50 has osteoporosisIt costs about 1.3 million dollars a year to treat this diseaseIt is estimated that by 2018 Canada will spend 32.5 billion dollars a year to treat osteoporotic fractures
6 Causes Caused by decreased osteoblast function Change in parathyroid activityMenopause is # 1 cause in women due to the decrease in estrogen levelsInsufficient dietary intake of vitamin C and D
7 Symptoms Height loss Curving spine or stooped posture Broken bones or fractures in the wrists and hips and spineProtruding abdomen- this is the most unrecognized symptom of osteoporosis as most don’t realize curvature of the spine cause less abdomen space so intestines have no where else to go so lean forward.Kyphorsis- “ Dowager Hump” caused by vertebral compression fractures and factures are disfiguring . This is the symptom most recognized in patients.A chest x-ray that shows osteopenia which is a condition where women’s bone mass is smaller than usual.
8 Risk factors Race – if you are white or of Southern Asian descent. Age – Older you get the more you chances of getting osteoporosis increases.Family History – greater risk if there is a history of it in your familyFrame Size – people who are exceptionally thin and have a small bodySedentary lifestyleLow body mass < 19 kg/m2Had an eating disorder like anorexia nervosa or bulimia. This cause high risk of lower bone density on back and hipsChronic alcoholismExcessive smoking
9 Risk factors continued Never been pregnantHad an early menopauseAbnormal absence of menstrual cycle or periods of amenorrhea causing low estrogen levelsLow testosterone in menTaking certain medications like corticosteroids and anti convulsantsWomen who have had surgery to remove an ovary as this accelerates bone lossPeople who have had an overactive thyroid
10 How it is detectedA bone density test should be done on women who have reached menopause as bone mass rapidly decreases each year.One type is called a dexa scan ( dual energy x-ray absorpomentry) which measures bone density and assesses your risk of bone fractures.A complete survey of dietary intake, drug history, and lifestyle can determine your risks of this condition.
11 Six steps to bone health and osteoporosis prevention ageAmount of calciumAdult women pregnant and lactatingmgWomen 25-491000mg50-64 taking estrogen100050-64 not taking estrogen1500mgAdult men 25-64Adult men over 651) get your recommended amounts of calcium and vitamin D. Recommended amount for vitamin D is iu/day2)Engage in regular weight bearing exercises like walking, stair climbing, and swimming at least 3 times a week to make bone s and muscles stronger.3) rehabilitation like physiotherapy to regain mobility and reduce pain.4) Avoid excessive alcohol and smoking5) using medication such as hormone replacement therapy whenever applicable6) talk to your doctor about bone health and make sure to have a bone density test.
13 TreatmentCalcitionin- naturally occurring hormone that increases bone mass in the spine and may lessen the pain of fractures already there.Raloxifene – It is a selective estrogen receptor modulator that prevents bone loss and spine fractures.Alendronate and risedronate - these are biphosphates that slow down the breakdown of bone and increase bone densityCalcium – keeps the bones strongVitamin D – helps you absorb calcium
14 Consequences Decresed quality of life Lost work days and disability Elderly patients develop pneumonia and blood clots in legs and veins that can travel to the lungsLowered self esteemDisfigurement (ex dowager hump)Decreased independence