SERVICES Osteoporosis
Osteoporosis: Early detection and prevention are the keys to success!
Current Canadian estimates are that 1 in 4 women and 1 in 8 men over the age of 50 have osteoporosis. People with osteoporosis are at increased risk for, and often suffer from, fragility fractures. A fragility fracture, or a low trauma fracture, can be sustained from a standing height or less, from a slip or a trip!
What is it? Osteoporosis is a skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fracture. Bone strength reflects the integration of two main features: bone density and bone quality.[i] Osteopenia is definded as a bone density of 78-99% or normal. There is an underlying change in the micro-architecture of the bone and the fracture risk is low to moderate. Osteoporotic bone is less than 78% of normal bone mass, and there is a disruption in the micro-architecture of the bone and there is and increased fracture risk.[ii]
Who is at risk of developing osteoporosis? There are major and minor risk factors that can lead to the development of osteoporosis.[iii]
Major risk factors include:
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individuals over 65 years of age
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previous vertebral compression fracture
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sustaining a fragility fracture over the age of 40 years
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family history of osteoporotic fracture
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systemic glucocorticoid therapy greater than 3 months
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malabsorption syndrome
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primary hyperparathyroidism
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propensity to fall
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osteopenia apparent on x-ray
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hypogonadism
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early menopause before the age of 45 years
Minor risk factors associated with the development of osteoporosis include:
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rheumatoid arthritis
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low dietary calcium
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smoking
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excessive alcohol or caffeine intake
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excessive weight loss
What are the consequences? Fragility fractures can have immediate health implications and can greatly impact an individuals' quality of life and the activities s/he chooses to participate in. The most often, the ability of an individual to live and care for themselves independently can be a longterm consequence of multiple fragility fractures.
What can be done to prevent osteoporosis? Maximizing peak bone mass is the best way to prevent osteoporosis. 26% of adult bone mineral aquired occurs in the 2 years around puberty, and this represents as much bone as most people will lose in their entire adult lives![iv] Peak bone mass is achieved generally by 30 years of age and is influenced by genetics, nutritional, hormonal, exercise and lifestyle factors. As we age our bone mass naturally decreases, it is therefore critical that we maximize our bone stores when we are younger so as to counter act this effect. This highlights the importance of encouraging regular physical activity from childhood, through play and weight bearing sports.
What can be done after a diagnosis of osteopenia or osteoporosis? Early interventions can stop the progression and assist in the prevention of fragility fractures! Besides pharmaceutical interventions, exercise, such as weight-bearing endurance activities and resistance exercise, has been shown to positively affect and improve the quality of an individuals' bone. Maintaining and individuals' physical activity not only positively affects their overall function, coordination and balance but it decreases their risk of falls in turn reducing their risk of fractures.[iii] For women, the optimal time period for effective exercise intervention is during the first 3-5 years following menopause.
Find out more about the Athlete's Care Bone Health Program
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[i] US National Instituition of Health 2000
[ii] Otts, S. “Osteoporosis Definition†February 1, 2008 <http://courses.washington.edu/bonephys/opop/opop.html>
[iii]“Fragility fractures, osteoporosis and you†Oct 2002. Osteoporosis Canada website. March 1, 2008 http://www.osteoporosis.ca/english/News/2002/first%20news%20test/default.asp?s=1
[iv]Marin, M. MelioGuide. The Guide to Stronger Bones. Ottawa, Ontario April 26 & 27th, 2008. Working with Osteopenia and Osteoporosis: An exercise program designed for the independent adult to improve bone density and reduce fall risk. Level 1.
