With World Osteoporosis Day being observed on October 20, NT BUZZ learns more about this disease that affects one in three women and one in five men, from the ages 50 and over
Danuska Da Gama | NT BUZZ
Osteoporosis, which literally means porous bones is concerned with the density and quality of bones; that are both reduced and weakened with age. This results in brittle bones, which are easily susceptible to fractures, mainly on the wrist, hips and spine.
Till a person reaches the late 20s, the bones are constantly dissolving and constructing themselves at a cellular level and there is a balance between the two. In fact bone density reaches its peak in this period.
However, after the thirties, there is a stir in that balance. Either there is an extensive amount of bone being broken down or not much reconstruction of the bones happening. Thus we gradually, begin to lose this gained bone density.
Orthopaedic and joint replacement surgeon Mahendra Kudchadkar tells us more about the disease:
Q. What are the different types of osteoporosis? Does it have anything to do with age, gender, hormones?
The first kind, Type 1 osteoporosis, is post-menopausal osteoporosis. It is the kind that affects, mainly women after menopause. After attaining menopause, there is a reduction in the hormone estrogen, which is responsible for the bone protection and rejuvenation. For this type, it is better to start preventive treatment before women reach this phase, as women begin to lose their bone density two years before they reach menopause.
Type 2 osteoporosis is senile osteoporosis. This is age-related and affects both women and men alike, women generally after the age of 55 and men mostly post 70 years.
There is also a third type induced by drugs and is called drug-induced osteoporosis. The drugs commonly responsible for this kind of osteoporosis are steroids and antiepileptic drugs.
Q. How severe is the condition in India?
This condition is a severe problem across India. 80 per cent of Indians are vegetarians, and so the protein consumption is less- which is an important element of building strong bones. Moreover, people living in urban areas have more chances of suffering from osteoporosis as the level of physical activity isn’t enough. Following a proper physical training regime is extremely crucial to prevent osteoporosis. Also, our exposure to sunlight is very poor, despite of an abundance of sunlight. Again this is more of a habit of urban dwellers who try to shield themselves from sunlight and stay in indoors. When the skin is exposed to sunlight, it creates vitamin D from cholesterol which aids in the calcium absorption from the diet which helps in having healthy bones.
Q. What is the Goan scenario like?
The Goa situation is far better when we compare it to the rest of the country as the people here mostly consume fish, which has high protein. While a healthy diet with proteins is essential, a high level of physical activity is extremely important to keep osteoporosis at bay.
Q. What are the symptoms to watch out for?
Osteoporosis doesn’t present itself with a specific set of symptoms which is why it is often called the silent killer. However, we can identify factors of suspicions.
Firstly, in terms of gender, a woman is more likely to have osteoporosis. Any woman who doesn’t do much physical activity, looks very thin and pale or has had an early menopause would need to get herself checked for osteoporosis.
Fractures to the wrist, hip and spine can point to the ailment as these are the common sites for osteoporotic fractures. Broadly, anyone over 65 should ideally get themselves checked for osteoporosis.
Q. What are the specific tests to be conducted to check for osteoporosis?
Diagnosis would involve blood tests. There is a gold standard test to confirm osteoporosis called the DEXA scan, which checks the strength of the bones in the spine, hips and wrist and is the benchmark for the diagnosis. Another test is an ultrasound of bone which serves as a screening tool.
Q. What precautions can one can take to curb the onset of osteoporosis?
Women in rural areas, even with a lesser diet of protein, were found to have stronger bones than women in urban areas. This is because the level of physical activity is more. In terms of priority, physical activity is the key element to be added to one’s daily schedule, followed by exposure to sunlight, followed by a protein rich diet. Diet contributes to only 20 per cent of prevention. Maintaining moderate physical activity as a routine is a good deterrent to osteoporosis.
Q. With several advancements in medicine, what’s the latest treatment for osteoporosis?
Alendronate is a new drug that can arrest bone loss. Synthetic parathyroid hormone therapy can be adopted which can be self-administered. Denosumab is another new drug for osteoporosis which is also being increasingly prescribed with good results.