Ramya Kannan

CHENNAI: Monday was an important day for senior citizens, and for women who have stepped past their menopause. It was a day allocated to check bone mineral density (BMD) to see if they are osteoporotic or headed that way.

Internationally observed as Osteoporosis day, Monday turned the focus on the BMD. More common with increased age, osteoporosis indicated the loss or thinning of bone tissue, which makes bones more brittle and thereby, more likely to cause fractures. Fractures are acknowledged as a leading cause of death in older people.

Bone tissue is built up by the deposition of minerals (mainly calcium) on a mesh of collagen fibres. It is continuously broken down and rebuilt in order to allow growth and repair. When resorption — the rate at which fibres, minerals and cells are broken down — is faster than formation, osteoporosis kicks in. “When it does, bones can crumble like a dry cookie, with even a small fall. Healing is slow and difficult, because bone regeneration is really slow,” T. P. Kalaniti, dean, MMC, explains.

V. S. Natarajan, senior geriatrician, says osteoporosis was recognised as a disease by the WHO in 1994. Women are more prone because of hormonal changes that occur in them, with one in three women over the age of 50 being affected by osteoporosis worldwide as against one in eight men. Dr. Natarajan explains that there has been a dramatic rise in hip fractures due to osteoporosis in Asia, thanks to an increase in the ageing population and changes in lifestyles.

At the Government General Hospital, a camp was organised on Monday by the Rheumatology Department and nearly 500 persons were screened for a basic bone density test. “The problem is that with osteoporosis, it is often undiagnosed and untreated until complications arise,” says R. Porkodi, head, Rheumatology Department, Madras Medical College. She adds that over 50 per cent of the patients in the Rheumatology Department were osteoporotic and 20-25 per cent had osteopenia, an earlier stage. Even in the general population, osteoporosis was on the higher side.

S. Rajeshwari, assistant professor in the Rheumatology Department, MMC, says there could be a number of factors including ingestion of steroids, a sedentary lifestyle, early menopause, excessive smoking and alcohol consumption, and a diet poor in calcium during the formative years. Prevention, she says, can start right after puberty, when healthy bone mass development begins. The peak period is between 20 and 30 years, when it is necessary to have proper diet and exercise. Aerobic exercise will go a long way in preventing osteoporosis later in life. It will increase blood supply to the musculature, strengthening the joints and consequently, bones.

While eating calcium-rich foods is sufficient for children, calcium and Vitamin D supplements are probably required later in life; on specific occasions such as pregnancy and lactation, post hysterectomy and oophorectomy (removal of ovaries); and for senior citizens.

Dr. Rajeshwari advised that it was also important to avoid falls and resulting fractures: by providing proper lighting, vision aids, if there is a vision defect, treading carefully over slippery floors and using footwear with a good grip. Dr.Natarajan adds, “it is often said that old age begins with the first fall and ends with the second, so we really need to create awareness among our populations about osteoporosis and the need for periodic testing. Basic BMD screening is very affordable,” he says.