EDITORIAL NOTE ON OSTEOPOROSIS IN OLDER PEOPLE

Received: 02-Aug-2021 Published: 16-Aug-2021

Editorial

Osteoporosis prevalence is increasing with an ageing demographic. Osteoporosis and fracture risk increases with age due to falls, frailty and comorbidities. Although there is a paucity of data in older populations over 70 years of age, the available evidence suggests that they benefit from multifactorial intervention including management of comorbidities, polypharmacy, fall risk, vitamin D and calcium optimisation and pharmacological interventions. Although the reduction in risk from these strategies is similar to younger people, the absolute risk reduction is greater in older people due to higher absolute fracture risk. Older people, however, present unique challenges. Although the imperative to treat is greater, there are multiple competing factors: frailty, comorbidities, drug interactions, greater likelihood of medical interventions for periodontal and dental disease, gastrointestinal issues limiting oral therapies and cognitive issues affecting adherence. Pharmacists are well placed as a key member of the multidisciplinary team to optimise management of this cohort.

Bones feel solid, but the inside of a bone is actually filled with holes like a honeycomb. Bone tissues are broken down and rebuilt all the time. While some cells build new bone tissue, others dissolve bone and release the minerals inside.

As we get older, we begin to lose more bone than we build. The tiny holes within bones get bigger, and the solid outer layer becomes thinner. In other words, our bones get less dense. Hard bones turn spongy, and spongy bones turn spongier. If this loss of bone density goes too far, it’s called osteoporosis. Over 10 million people nationwide are estimated to have osteoporosis.   

As we get older, we begin to lose more bone than we build. The tiny holes within bones get bigger, and the solid outer layer becomes thinner. In other words, our bones get less dense. Hard bones turn spongy, and spongy bones turn spongier. If this loss of bone density goes too far, it’s called osteoporosis. Over 10 million people nationwide are estimated to have osteoporosis.

It’s normal for bones to break in bad accidents. But if your bones are dense enough, they should be able to stand up to most falls. Bones weakened by osteoporosis, though, are more likely to break. “It’s just like any other engineering material,” says Dr. Joan McGowan, an NIH expert on osteoporosis. If you fall and slam your weight onto a fragile bone, “it reaches a point where the structures aren’t adequate to support the weight you’re putting on them.” If the bone breaks, it’s a major hint that an older person has osteoporosis.

Broken bones can lead to serious problems for seniors. The hip is a common site for osteoporosis, and hip fractures can lead to a downward spiral of disability and loss of independence. Osteoporosis is also common in the wrist and the spine. The hormone estrogen helps to make and rebuild bones. A woman’s estrogen levels drop after menopause, and bone loss speeds up. That’s why osteoporosis is most common among older women. But men get osteoporosis, too.