On Mother’s Day, Mrs. Kim was preparing a meal for her son who had come to visit. While moving a pot, she suddenly strained her back. Despite her insistence that it was just a regular part of aging and would improve in a few days, her son took her to the hospital. Tests revealed she had suffered a spinal fracture due to osteoporosis.
Celebrating time with your family offers an excellent opportunity to check on your parents’ health. Osteoporosis, in particular, is a condition that often goes undetected in older adults. Neglecting bone health can lead to fractures that could have been prevented with proper care. It’s crucial to assess your parents’ bone health thoroughly.
Many women over 60 have osteoporosis, often without realizing it
Medical experts report that osteoporosis weakens bones and increases fracture risk. The condition often has no noticeable symptoms before a fracture occurs, making it easy for individuals to be unaware of their condition. Typically, women are at higher risk for osteoporosis.
Nearly half of women in their early 60s, over three-fifths of those in their late 60s, and three-quarters of those in their 70s have osteoporosis. Because osteoporotic bones are thin and porous, they can easily break from minor impacts that wouldn’t normally cause fractures.
An osteoporotic fracture not only increases pain and mortality risk but also raises the likelihood of subsequent fractures. Therefore, older adults should maintain strong bones through treatment and management or undergo early diagnosis of fracture risk.
If you notice your parents have lost more than 3 cm (approximately 1.2 inches) in height during a recent visit, they may have already sustained a spinal fracture. The spine is the most common site for osteoporotic fractures, with two-thirds of patients unaware of their condition.
Ignoring spinal fractures can lead to additional fractures and often results in the spinal deformity commonly known as a dowager’s hump. In severe cases, this can even lead to lower limb paralysis. One-third of spinal fracture patients experience persistent, severe pain even two years after the fracture.
The primary diagnostic tool for osteoporosis is a bone density test. A T-score of -2.5 or lower indicates osteoporosis. For every 1-point decrease in T-score, fracture risk increases 2 to 3 times compared to those with normal bone density. A T-score below -3 indicates a high fracture risk, requiring immediate treatment.
Bone density tests are quick, typically 5 to 10 minutes, and inexpensive. They’re easily accessible at local health centers or hospitals. Tests are recommended for premenopausal women with amenorrhea for over six months, postmenopausal women, men over 70, and those with a history of osteoporotic fractures.
Osteoporotic fractures in the spine, hip, wrist, and ankle significantly impact quality of life
Osteoporotic fractures often signal the potential for further fractures. If your parents have a history of such fractures, they should be cautious about re-fracturing. Even one previous fracture likely indicates significantly weakened bones, classifying them as high-risk regardless of their bone density score.
This high-risk group includes patients who have experienced fractures in the past 1-2 years, those with a T-score below -3 even without prior fractures, individuals with a history of osteoporotic fractures and a T-score below -2.5, and patients who have experienced fractures while on osteoporosis medications.
As the elderly population grows, osteoporotic fractures are increasing by an average of 9.3% annually, with re-fractures also on the rise. Research shows that half of all re-fractures occur within two years of the initial fracture. Re-fractures typically incur higher treatment costs and increased mortality rates.
Dr. Kim Sung Kyu, an orthopedic specialist at Chonnam National University Hospital, emphasizes that osteoporotic fractures in the spine, hip, wrist, or ankle hinder mobility and cause severe pain, significantly reducing quality of life.
Dr. Kim stresses that osteoporosis treatment is crucial, especially for older adults, as prolonged bed rest can lead to serious complications. The primary goal of treatment is fracture prevention, with treatment choices based on fracture risk. For high-risk patients, bone-forming agents are typically recommended as first-line treatment.
Osteoporosis medications fall into two categories: bone resorption inhibitors that prevent old bone destruction and bone-forming agents that promote new bone creation. Bone-forming agents are recommended as the primary treatment for high-risk patients with previous fractures or bone density scores below -3.
Dr. Kim notes that consistent treatment is crucial after consulting with specialists to select the most suitable medication. Observations of high-risk patients showed that recently developed dual-action bone-forming agents, administered monthly for a year, can significantly improve bone density.
He adds that even after completing treatment with bone-forming agents, fracture risk remains. It’s important to continue with long-term maintenance therapies, such as bisphosphonates administered every six months.