The lifetime risk for osteoporosis in the UK almost half for women and 1 in 5 for men. This disease is not, however, an inevitable part of ageing. There are many ways in which you can prevent yourself becoming one of the estimated 3 million sufferers in the UK.
Gradual bone loss is a natural part of ageing but the significant deterioration of bone that leads to osteoporosis can be prevented in many cases. Early diagnosis is important to harness this epidemic.
The occurrence increases with age, especially after 50, but it can be prevented in many cases through a balanced mix of nutrients, exercise and hormones.
Normal ageing causes a decrease in bone density, to varying degrees, with no incidence of fractures. Osteoporosis develops when there is a marked decrease in bone mineral density, often resulting in fractures, associated pain, anxiety and loss of independence.
This disease can be effectively treated, but the key is to recognise whether you are at risk and take positive steps to help prevent its occurrence.
Osteoporosis was only officially defined as a disease in 1994.
It is now acknowledged as a high priority health concern.
Osteoporosis is described as the 'silent epidemic', the disease that is increasing in global significance as the population grows and ages, but occurs without warning to its sufferers. The first signs of the disease are often fractures as a result of a minor fall or knock, which in reality is a symptom that the disease is already present. The rate of increase of fractures resulting from osteoporosis has been estimated to increase from 1.7 million in the UK in 1990 to 6.3 million by the year 2050.
The outward appearance of bones does not alter when osteoporosis develops, but looking at the inner structure tells a different story. The lattice work of bones change from that comparitive to a sponge, to one of lace, an open porous structure. Hence the name, osteoporosis.
Bones are living tissue
Bone is constantly being removed (bone resorption), and renewed, in a continuous cycle known as bone turnover. As we get older, bone turnover swings from the predominance of bone renewal, or in early years of life, through to our 40s and 50s when bone resorption starts to outstrip this process, leading to overall bone loss.
How we use our skeleton will affect its strength
Medieval bowmen can be identified by their skeletons, through the high bone density of their shoulders.
In sport today, tennis players have a 30% higher bone density (strength) in their serving arm compared to their non-serving arm
Bone loss - what can we do?
The risk of osteoporosis and the resulting fractures is related, in part, to the maximum bone strength that we acquire from childhood to early adulthood. Thereafter it is related to the rate of bone loss. Although our family history plays a large role in determining our bone strength and rate of bone loss, there is a lot we can do to help ourselves.
There is just over 1 kg calcium in the body, 99% of which is present in the bones
We can consume a balanced diet, adequate in calcium and vitamin D; partake in exercise on a regular basis and take simple steps to reduce the risk of falls that can result in fractures.
Early diagnosis of the significant bone loss is important to harness this epidemic and bone scans are becoming more widely available across the country for this purpose.
The effect of our sex?
1 in 3 women and at least 1 in 12 men will develop osteoporosis during their lifetime. The current estimate of the number of people that suffer from the disease in the UK is 3 million people, but many cases go undiagnosed.
Women are at greater risk of developing osteoporosis, particularly after the menopause when the reduction of hormonal protection causes accelerated bone loss. More than one-third of bone is lost from the skeleton during the 10-15 years after the menopause.
Men account for 20% of all osteoporosis cases and 1 in 6 men are likely to sustain an osteoporotic fracture by the age of 90. Most of these cases have no obvious cause, other than age, but one fifth are caused primarily by low levels of testosterone.
Every 3 minutes, somebody will suffer a fracture as a result of osteoporosis, the most prevalent fractures being at the hip, back and wrist. Wrist fractures are particularly common in women in their fifties.
These fractures result in disability and a lack of mobility and independence, ultimately leading to death in many cases. The lifetime risk of suffering an osteoporotic fracture is 30-40% for women, and 13% for men.
The most common sites for osteoporotic fractures are the wrist, spine and hip.
In the UK each year, there are 60,000 hip fractures and 50,000 wrist fractures as a result of osteoporosis.
Hip fractures account for more than 20% of orthopaedic bed occupancy in the UK.
Osteoporosis costs the NHS and government £1.5 billion each year.
Other bone disorders
Osteomalacia is often confused with osteoporosis, but rather than the loss of bone mass, it is the softening and weakening of the bone, due to a deficiency of vitamin D and calcium.
Other bone disorders include Paget's disease, osteoarthritis, rheumatoid arthritis, tumours and infections such as abscesses.