Falls in the elderly often affect people suffering from osteoporosis for years. The fall of an elderly person (usually women) with this disease often results in a fracture of the femur, hospitalization, disability, often psychosis, and often death. Therefore, osteoporosis of the elderly should be given special attention.
Osteoporosis is a social disease that threatens health and life
According to epidemiological research, over 6 million people are affected in Poland. Annually, about 14 thousand. fractures associated with this disorder, which is very often characterized by complicated course, with mortality up to 40%. A report prepared by the World Health Organization (WHO) shows that osteoporosis is becoming an increasing health problem. It is estimated that in 2010, 6.3 million fractures due to osteoporosis are likely to be registered worldwide (in 1990 there were 1.7 million). It is a metabolic bone disease that causes loss and damage to bone mass, which in turn leads to increased susceptibility to fractures. Osteoporosis does not manifest itself in any particular way.
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How to recognize the advanced form of osteoporosis?
Unfortunately, in the majority of patients - the first recognized symptom is usually a fracture, most often around the wrist, femoral neck and spine. Then it is too late for prophylaxis and long-term specialist treatment is necessary. In the case of older people, it usually leads to immobility, disability and increasing mental disability and dementia (if it does not end in death).
Main risk factors for osteoporosis:
(whose relationship with the increasing risk of bone fractures has been strictly proven)
• previous fracture after a minimum injury,
• family tendency to osteoporosis, manifesting in bone fractures after minor injuries (or without injury) to parents or siblings, especially the fracture of the femoral neck of the mother,
• early menopause and long-term estrogen deficiency in the post-menopausal woman's body,
• androgen deficiency (testosterone) in men,
• long-term use of glucocorticoids.
Factors - whose occurrence accelerates the development of osteoporosis:
• age over 65 years,
• calcium deficiency in the diet of older people,
• vitamin D deficiency (only 20% of vitamin D comes from food sources, 80% of vitamin D is synthesized in the skin under the influence of the sun, older people spend most of their time indoors, especially during the autumn and winter, thus preventing the formation of vitamin in their bodies),
• chronic use of a number of medicines, including anticoagulants, anticancer, anticonvulsants, some diuretics - furosemide (which is often the case in the elderly), thyroid hormones and many others,
• abuse of coffee, alcohol,
• smoking,
• long-term immobilization,
• osteoporosis may accompany many diseases (eg renal failure, hyperparathyroidism and others).
Special threat of osteoporosis - accumulation of risk factors
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The more risk factors, the greater the possibility of developing osteoporosis and the risk of bone fractures. The coexistence of three-four factors of osteoporosis is a disturbing signal that should lead to interest in the condition of one's own bones. However, osteoporosis can be prevented if it is detected early.
We apply prophylactic diagnosis to people at risk groups
The degree of osteoporosis risk and, consequently, bone fracture can be determined already for many months and years before the disease becomes dangerous. Specialist research is necessary for this purpose. One of them is densitometry, which is based on the determination of bone mineral density (BMD), based on the amount of gamma radiation absorbed by bone tissue. The test is painless, lasting from a few to several minutes. Densimetric testing should be obligatory carried out after the age of 65. In the case of doubts, it is necessary to perform a full densimetric computer examination.
In the treatment of osteoporosis, prevention is the most important, including calcium and vitamin D supplementation.
We should remember that the element that determines the condition of our bones is calcium. Its deficiency causes a loss of bone building substance - hydroxyapatil, which leads to a reduction in bone strength at fracture. To prevent this, use a proper diet, rich in both calcium and vitamin D, which facilitates its absorption. The correct supply of calcium and vitamin D is important throughout life, especially in the elderly.
According to recent findings of the demand for calcium in adulthood, it looks as follows:
- about 1000 mg for a healthy adult human
- about 1500 mg for a woman during menopause without hormonal estragen therapy
- about 1,000 mg for a woman during menopause using such therapy
- around 1500 to 1700 for a woman and a man over 70 years of age.
Prevention and treatment with calcium-vitamin preparations has proven effectiveness. This method of therapy is safe for the body.
Other methods of osteoporosis prophylaxis - moderate mobility is particularly recommended
The moderate physical activity, which in any case is worth recommending for the elderly, has a beneficial effect on the condition of our bones. In other words, everyday walks and all other forms appropriate to the condition of recreation (swimming, gardening, etc.) are recommended.
It is now believed that osteroporosis is not just a women's problem.
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In the United States, over half a million men suffer from this disease, more than three million are in the high-risk group. In men, as well as women, with age, bone mass decreases and hip bone fractures. In the Netherlands, 15,107 cases of hip fractures were analyzed. The study also measured bone thickness in a group of 6,000 women and men aged 55 years and older. Based on the results of the study, it was concluded that the risk of hip fracture in an 80-year-old person is 13 times greater than in a 60-year-old. In addition, it has been found that osteoporosis in men usually develops 5 years later than in women. In the light of recent reports, there is a basis for starting preventive activities involving not only women but also men.
Here are a number of practical recommendations that will help prevent this insidious disease:
1. One should eat foods rich in calcium (milk and its products: yogurt, kefir) and vit. D (fish oil, egg yolk).
2. If a deficiency is found, the patient should be given supplements of calcium and vitamin supplements.
3. Fight overweight.
4. Use (moderately) from sunny weather (under the influence of sunlight, vitamin D is formed in the skin).
5. Change your lifestyle to a more active one.
6. Minimize the stimulants.
7. In older age, situations that may lead to falling and, in consequence, bone fractures should be avoided (eg staying at home, when there is slippery, etc.).
8. Periodically carry out a densimetric test.
WARNING!
I devote so much attention to the prevention and treatment of osteoporosis because the disability caused by the severity of this disease significantly reduces the quality of life of old patients, it is one of the causes of invalidity and subsequent chronic depression. It can finally be an indirect reason for the death of the patient.
Doctor of Medicine Janusz Krzyżowski
Psychiatrist
Private office tel. 22 833 18 68
00-774Warszawa, Dolna 4 lok. 15
