Osteoporosis

Question 1

what is osteoporosis

Answer 1

Osteoporosis
◦ Decrease in amount of bone
◦ Type 1 – postmenopausal women
◦ Type 2 – men and women > 70 years
◦ Silent disease, progressing over many
years
◦ Condition of fragility with decreased
bone mass and micro-architectural
deterioration contributing

Question 2

how does bones change with age

Answer 2

Linear growth of bones up to 18 years
Peak bone mass achieved by 25-30 years
Maintenance up to 35-40 years
Older, bone loss of 0.3-0.5% yearly

Question 2

Main dietary risk factors

Answer 2

Calcium
 Deficiency results in impaired bone deposition,
increased bone resorption
 Supplementation if family history/early signs;
calcium carbonate/calcium citrate
Vitamin D
 Major determinant of Ca absorption
 Older adults - lower vit. D production, reduced
activation

Question 3

Other dietary risk factors

Answer 3

Alcohol
 increases PTH levels
Protein
 Hypercalciuric effect
Vitamin K
 Nurses’ Health Study: lowest quintile 30% higher
risk of fractures
Vitamin C
 Impaired collagen synthesis if intake low

Question 4

Non - dietary risk factors

Answer 4

Weight bearing exercise
◦ Reduces loss of bone mass
◦ Maximise bone mass when young
Smoking
◦ Smokers have reduced BMD
◦ Delays time for fracture to heal
◦ Produce less oestrogen (an anti-resorptive)

Question 5

Case study: New Zealand

Answer 5

1. Care of people who sustain hip fractures to be documented in the Australian and New
   Zealand Hip Fracture Registry, and, from 2023 to 2030, all patients to receive best practice
   as described by the Australian and New Zealand Hip Fracture Care Clinical Care Standard.
2. Universal access to FLS to be available from 2025, and for the care of individuals who sustain
   fragility fractures at any relevant skeletal site to be benchmarked against the second edition
   of the Clinical Standards for FLS in New Zealand
3. Ensure reliable identification, investigation and interventions for all New Zealanders at high
   risk of sustaining fragility fractures
4. New Zealanders aged 50 years or over to complete the Know your Bones™ online self-
   assessment and discuss with their general practitioner. Develop awareness campaigns
   relating to preserving physical activity, healthy lifestyles and reducing environmental hazards
5. Incorporate content relating to bone health into the school curricula for science, health and
   physical education