Final Review Important Concepts - Osteoporosis Flashcards
What is Osteoporosis?
Osteoporosis Literally means “porous bone.” This disease is characterized by too little bone formation, excessive bone loss, or a combination of both, leading to bone fragility and an increased risk of fractures of the hip, spine and wrist.
About Osteoporosis What is a sign of osteoporosis? How does bone density change as you get older? What demographics usually get more osteoporosis?
Having weak bones that easily break is a sign of osteoporosis. It is normal for your bones to become less dense as you grow older, but osteoporosis speeds up this process. This condition can particularly lead to problems in older age because broken bones do not heal as easily in older people as they do in young people, and the consequences are more serious. In general, osteoporosis is more common in women, and they often develop it at a younger age. Getting older does not mean that you will automatically develop osteoporosis, but the risk does increase with age. People over the age of 70 are more likely to have low bone density. Plus, the risk of falling increases in old age, which then also makes fractures more likely. But there are several things you can do to protect and strengthen your bones — even if you are already older.
What are Symptoms of Osteoporosis?
Symptoms
Osteoporosis often goes undetected at first.
Sometimes there are obvious signs that a person has osteoporosis – they may ”shrink” a little and develop a stooped posture, for example. But often the first sign that someone has osteoporosis is when they break a bone, sometimes without knowing how or why it happened. This kind of break is called a “spontaneous fracture.”
When bone mass is lost the risk of breaking a bone (fractures) is higher. Osteoporosis that has already caused a fracture is referred to as “established” osteoporosis.
The bones of the spinal column (vertebrae) are the most likely to break or “collapse” in someone who has osteoporosis. Sometimes this will cause back pain, but most people do not notice anything.
Broken vertebrae are one reason why many older people stoop over and develop what is often called a “dowager’s hump” at the top of their spine.
Osteoporosis also commonly affects the wrist, the upper arm and the femur (thigh bone).
What is a Spontaneous Fracture?
Osteoporosis often goes undetected at first.
Sometimes there are obvious signs that a person has osteoporosis – they may ”shrink” a little and develop a stooped posture, for example. But often the first sign that someone has osteoporosis is when they break a bone, sometimes without knowing how or why it happened. This kind of break is called a “spontaneous fracture.”
What is “established osteoporosis”?
When bone mass is lost the risk of breaking a bone (fractures) is higher. Osteoporosis that has already caused a fracture is referred to as “established” osteoporosis.
EXTRA:
Symptoms
Osteoporosis often goes undetected at first.
Sometimes there are obvious signs that a person has osteoporosis – they may ”shrink” a little and develop a stooped posture, for example. But often the first sign that someone has osteoporosis is when they break a bone, sometimes without knowing how or why it happened. This kind of break is called a “spontaneous fracture.”
When bone mass is lost the risk of breaking a bone (fractures) is higher. Osteoporosis that has already caused a fracture is referred to as “established” osteoporosis.
The bones of the spinal column (vertebrae) are the most likely to break or “collapse” in someone who has osteoporosis. Sometimes this will cause back pain, but most people do not notice anything.
Broken vertebrae are one reason why many older people stoop over and develop what is often called a “dowager’s hump” at the top of their spine.
Osteoporosis also commonly affects the wrist, the upper arm and the femur (thigh bone).
Which bones are most likely to break in someone with osteoporosis?
What other bones are commonly affected?
The bones of the spinal column (vertebrae) are the most likely to break or “collapse” in someone who has osteoporosis. Sometimes this will cause back pain, but most people do not notice anything.
Broken vertebrae are one reason why many older people stoop over and develop what is often called a “dowager’s hump” at the top of their spine.
Osteoporosis also commonly affects the wrist, the upper arm and the femur (thigh bone).
EXTRA:
Symptoms
Osteoporosis often goes undetected at first.
Sometimes there are obvious signs that a person has osteoporosis – they may ”shrink” a little and develop a stooped posture, for example. But often the first sign that someone has osteoporosis is when they break a bone, sometimes without knowing how or why it happened. This kind of break is called a “spontaneous fracture.”
When bone mass is lost the risk of breaking a bone (fractures) is higher. Osteoporosis that has already caused a fracture is referred to as “established” osteoporosis.
What are Causes of Osteoporosis?
Causes
Inside bones there is a supporting structure with interconnecting bony plates and rods called trabeculae. This structure is called trabecular or spongy bone because it looks a bit like a sponge or honeycomb.
Osteoporosis develops when a large amount of the spongy bone tissue breaks down, leaving bigger spaces. The bone becomes more porous as a result. This affects the fine structure of the bones, and they become brittle. Some people’s bones become so fragile that even tripping over something or lifting a heavy shopping bag is enough to cause vertebrae to break.
EXTRA:
Bone density starts to gradually decrease once you turn 30, even if you do not have osteoporosis. Around the age of 50 this process speeds up, especially in women. Before menopause, the female sexhormone estrogen helps protect the bones by slowing down bone loss. So after menopause, when this hormone level drops, bone tissue is lost more quickly.
If no cause for the bone loss can be found, it is called primary osteoporosis. Secondary osteoporosis is when bones have become fragile due to something else, like another condition or long-term corticosteroid use.
At what age does bone density start to decrease? At what does this increase?
Causes
Bone density starts to gradually decrease once you turn 30, even if you do not have osteoporosis. Around the age of 50 this process speeds up, especially in women. Before menopause, the female sexhormone estrogen helps protect the bones by slowing down bone loss. So after menopause, when this hormone level drops, bone tissue is lost more quickly.
EXTRA:
Causes
Inside bones there is a supporting structure with interconnecting bony plates and rods called trabeculae. This structure is called trabecular or spongy bone because it looks a bit like a sponge or honeycomb.
Osteoporosis develops when a large amount of the spongy bone tissue breaks down, leaving bigger spaces. The bone becomes more porous as a result. This affects the fine structure of the bones, and they become brittle. Some people’s bones become so fragile that even tripping over something or lifting a heavy shopping bag is enough to cause vertebrae to break.
Bone density starts to gradually decrease once you turn 30, even if you do not have osteoporosis. Around the age of 50 this process speeds up, especially in women. Before menopause, the female sexhormone estrogen helps protect the bones by slowing down bone loss. So after menopause, when this hormone level drops, bone tissue is lost more quickly.
If no cause for the bone loss can be found, it is called primary osteoporosis. Secondary osteoporosis is when bones have become fragile due to something else, like another condition or long-term corticosteroid use.
How does menopause affect bone loss?
CAUSES
Before menopause, the female sexhormone estrogen helps protect the bones by slowing down bone loss. So after menopause, when this hormone level drops, bone tissue is lost more quickly.
EXTRA:
Causes
Inside bones there is a supporting structure with interconnecting bony plates and rods called trabeculae. This structure is called trabecular or spongy bone because it looks a bit like a sponge or honeycomb.
Osteoporosis develops when a large amount of the spongy bone tissue breaks down, leaving bigger spaces. The bone becomes more porous as a result. This affects the fine structure of the bones, and they become brittle. Some people’s bones become so fragile that even tripping over something or lifting a heavy shopping bag is enough to cause vertebrae to break.
EXTRA:
Bone density starts to gradually decrease once you turn 30, even if you do not have osteoporosis. Around the age of 50 this process speeds up, especially in women.
What is Primary vs Secondary osteoporosis?
CAUSES
If no cause for the bone loss can be found, it is called primary osteoporosis. Secondary osteoporosis is when bones have become fragile due to something else, like another condition or long-term corticosteroid use.
EXTRA:
Causes
Inside bones there is a supporting structure with interconnecting bony plates and rods called trabeculae. This structure is called trabecular or spongy bone because it looks a bit like a sponge or honeycomb.
Osteoporosis develops when a large amount of the spongy bone tissue breaks down, leaving bigger spaces. The bone becomes more porous as a result. This affects the fine structure of the bones, and they become brittle. Some people’s bones become so fragile that even tripping over something or lifting a heavy shopping bag is enough to cause vertebrae to break.
EXTRA:
Bone density starts to gradually decrease once you turn 30, even if you do not have osteoporosis. Around the age of 50 this process speeds up, especially in women. Before menopause, the female sexhormone estrogen helps protect the bones by slowing down bone loss. So after menopause, when this hormone level drops, bone tissue is lost more quickly.
WHAT ARE RISK FACTORS OF OSTEOPOROSIS?
Risk factors
There are a number of factors that can increase someone’s risk of developing osteoporosis. Some can be influenced, whereas others cannot. The main risk factors for osteoporosis include:
Age: As we get older, our bone density decreases and the risk of developing osteoporosisincreases. Men over the age of 65 and post-menopausal women are at the greatest risk.
Sex: Women develop osteoporosis more often than men, and they are also more likely to have bone fractures.
Low body weight (compared to body size)
Diet low in calcium
Vitamin D deficiency
Lack of exercise
Family history: Women whose mother or father broke their hip because of osteoporosis are at greater risk of developing osteoporosis themselves.
Smoking
Drinking a lot of alcohol
Long-term steroid use
Use of other medications, such as some antidepressants (SSRIs) or diabetes medicines (glitazones)
Conditions such as rheumatoid arthritis or hyperthyroidism (an overactive thyroid gland)
What is the Prevalence of Osteoporosis?
Prevalance
According to the Robert Koch Institute, 8% of men and 13% of women in Germany between the ages of 60 and 69 report being diagnosed with osteoporosis. But it is not known exactly how many people in Germany actually have osteoporosis or how many bone fractures are caused by osteoporosis. Also, not everyone with osteoporosis ends up with a bone fracture.
Hip fractures in particular can have serious consequences. This is a problem that almost only affects older people: In Germany, 6 to 7 out of 1,000 people over the age of 65 break their hip bone (femoral neck) every year. Most of them are over the age of 75.
How is Osteoporosis diagnosed?
Diagnosis
If it is thought that someone might have osteoporosis, their bone density can be measured. Here the amount of minerals in the bones is measured, which can help to estimate how high the risk of a bone fracture is. This test is also done to help plan treatment or see how well it is working.
The results of bone mineral density tests are reported as T-scores. According to current definitions,
a T-score above -1 is normal,
a T-score between -1 and -2.5 is below normal, and
a T-score of -2.5 or less means you have osteoporosis.
A bone mineral density test on its own can only partially predict a person’s risk of bone fractures. There are other factors besides bone density that influence the health of your bones. These include the quality of the bone tissue and your skeletal structure. Measurements of bone mineral density are not 100% accurate either, and it is also important to take into account things like a person’s general health, other conditions and any risk factors.
Other types of tests may be used too - for example, a blood test could be used to rule out other conditions that could be causing the loss of bone mass.
How can you prevent osteoporosis and prevent injury while older?
Prevention
There are several things you can do on your own to protect your bones and lower your individual risk of developing osteoporosis. These include eating a diet rich in calcium, getting regular exercise and quitting smoking. Making sure your body has enough vitamin D is also important. Dietary supplements can be used as an additional source of calcium and vitamin D if you are not getting enough in your diet.
Femoral neck fractures are especially likely to have serious consequences because most people do not fully recover afterwards. Although osteoporosis can increase the likelihood of this kind of fracture, falls are the greatest risk factor for hip fractures.
So it is especially important for older people to try to prevent falls. Getting exercise can help here: Physical activity can make you feel more confident and improve your coordination. It is also important to take care of hazards around your home that could increase your chances of slipping or stumbling. These may include things like loose cables, rugs and door thresholds.
What is Treatment for Osteoporosis?
Treatment
Even if someone already has osteoporosis, it is important for them to do regular exercise and get enough calcium and vitamin D. In Germany, statutory health insurances cover the cost of calcium or vitamin D supplements if a doctor has prescribed them.
Osteoporosis can be treated with several drugs designed to slow bone loss and increase the production of new bone tissue. These include bisphosphonates and some hormonal or hormone-like medications. These kinds of drugs can have different types of side effects, though, and may not be suitable for everyone. They are only considered if someone has already broken a bone, or if their risk of bone fractures is high – for example, if their bone density is very low or if they have a combination of different risk factors, like low body weight, old age and a higher risk of falling.
Hormone products, like those used to treat menopause symptoms, can also lower the risk ofosteoporosis-related bone fractures when taken over the long term. But long-term hormone therapy during or after menopause increases the risk of cardiovascular diseases and breast cancer.
For this reason it is only rarely recommended as treatment for osteoporosis. The pros and cons of this treatment should be carefully weighed.
