By Sonal Sarda
We’ve all heard about osteoporosis – it’s that thing that happens to older women, right, that makes their bones get weak? Well, what if it isn’t always age-related (or gender specific)? What if bone health is something you should care about before you get old?
Osteoporosis is a condition that leads to weakening of bones – their density decreases, increasing the likelihood of a fracture. It is usually related to age: as women approach menopause, hormonal changes in their bodies result in a deficiency of estrogen, which causes bone density loss.
According to the International Osteoporosis Foundation, “the lifetime risk for osteoporotic fractures in women is 30-50 percent,” while for men, the risk in men is about 15-30 percent. One out of three females in India suffers from osteoporosis, and that the peak of incidence in the country is at a much lower age than compared to the Western countries. While the latter sees peak of incidence around 70-80 years of age, in India, osteoporosis may occur in women who are 10-20 years younger than their Western counterparts, that is, at the age of 50-60.
A 2013 study found that an estimate of over 50 million people in India were either osteoporotic or had low bone mass.
Doctors say that our diet and sedentary lifestyles mean that our bones may be deteriorating younger, and that bone health is something to be careful about, irrespective of age. So what should we be looking out for?
Symptoms of osteoporosis
There are no clear or specific symptoms of this condition: Dr. (Prof.) Raju Vaishya of Apollo Hospitals, Delhi, uses a term often deployed in connection with osteoporosis when he calls it a “silent disease”.
“Generalised body pain, uneasiness and fractures from simple falls are some of the tell-tale signs,” says Dr. Sandeep of HOSMAT Hospital in Bengaluru. The wrists, back and hips are the most vulnerable to fractures. But in order to be certain, you will need to consult a doctor, who will then order a scan.
What is the check-up for osteoporosis like?
The medical check-up entails a bone density scan; this will assess the quality of your bone. It is done through a dual-energy X-ray absorptiometry (DEXA) scan, which measures your bone mineral density.
A DEXA scan is quick, and similar to an X-Ray; but much more enhanced in its scanning. A full body scan takes half an hour at the most, while scans of specific parts take less time. Not all standalone diagnostic centres have the machinery needed for a DEXA scan, but nearly all multi-speciality hospitals that have a department of orthopaedics offer the test. A full scan can be expensive, costing anywhere between Rs 3,000 and Rs 6,000. But so much better than surgeries and post-op care from falls that can run into lakhs. Reports are usually handed over the same day.
With the help of the scan, doctors can grade the severity of your condition and treat you accordingly.
If the condition is solely as a result of age, then it can last with you for your entire lifetime. But if the disease’s onset is because of malnutrition, it may be corrected. Osteoporosis due to hormonal imbalances can also sometimes be reversed.
Treatment mostly involves tablets, injections, calcium and other supplements; however, in some severe cases, there may be a need for hormone-based treatment as well.
Who should worry about it?
When contacted, several doctors spoke of how Vitamin D deficiency and calcium deficiency could also be responsible for osteoporosis – age wasn’t the only factor. “There can be primary and secondary factors responsible for osteoporosis. While the primary factor is hormonal change, brought about because of age, secondary factors are constituted by smoking, unhealthy lifestyles, deficiencies of vitamins and calcium, excessive thyroid hormone as well as being on steroids,” says Dr Vaishya.
Insufficient nutrition and reduced physical activity are key reasons doctors identify for the disease affecting women at a younger age. Dr. Ajay Bhambri, an orthopaedic at the Fortis Hospital, Mohali, says that while earlier, women needed to start getting themselves checked in their early forties, it is now important that women start exercising caution after the age of 35 itself.
If lifestyle is such a large factor, wouldn’t the problem be seen across genders?
“Hormonal changes in men occur at a later stage, say around 60-65,” says Dr Bhambri. Men aren’t immune to osteoporosis (take a look at this set of facts by the American National Osteoporosis Foundation) – it’s just that the incidence and onset of this condition is much later in men.
Can you beat osteoporosis?
You can’t stop bone density loss due to age, but you can certainly slow the process down, and reduce its severity, doctors say. Set yourself a regular exercise schedule right away. Increase calcium intake, have more leafy vegetables and milk products. Oral calcium intake in case of calcium deficiencies may also help. And start going for regular checkups – once a year after you hit the 35-40 age group.
So the next time around you, or someone around you, fractures themselves because of a fall that a few years back would have meant a sprain at the most, you know it’s time for a check-up.