Osteoporosis risk factors
What is osteoporosis?
Osteoporosis (porous bones) is thinning of the bones. As people age, their bone mineral density (BMD) level drops and the risk of fracture increases. Bone mineral density is measured by a DEXA, a special type of X-ray. People in their 70s and 80s often have less BMD than young adults.
Bone is a living tissue made up of proteins and minerals such as calcium and phosphorus. The body constantly remodels and rebuilds bones to keep them strong. However, in osteoporosis, bones break down faster than they rebuild, because the body takes calcium from the bones faster than the person can replace it. Although bones remain the same size, they become thinner and more brittle.
Osteoporosis is a ‘silent’ medical condition — it is not painful until there is a fracture. Fractures usually occur in the spine, wrist or hip. Hip fractures may have a dramatic effect on a person’s quality of life. About 50 per cent of people need ongoing care after a hip fracture, and never return to a fully independent lifestyle.
Preventing fractures
If you are at risk of osteoporosis it is important that you reduce your risk of falling. Ask your pharmacist or doctor to review your medicines, as some may cause low blood pressure or interfere with balance. You should also have your eyesight tested, as good sight is needed to avoid tripping over or bumping into objects. If you live alone, you may wish to consider wearing an alert system around your neck. This can be activated if you have a fall and cannot move.
The following tips may also help reduce the risk of falls:
- avoid high heels and wear non-slip soles;
- do weight-bearing exercise to improve your muscle strength and balance;
- use a walking stick, if falling is a problem; and
- get out in the sun (without getting sunburnt) as vitamin D, obtained through sunlight, is needed to help with the absorption of calcium.
Who is at risk?
Women tend to be more at risk of osteoporosis than men, with a relatively rapid loss of BMD in the first 5 to 7 years after menopause. Women who have had a hysterectomy before normal menopause also have an increased risk.
Alcohol is toxic to the molecules that help build bone, particularly in men. High alcohol intake increases the risk of osteoporosis. Other at-risk groups include Caucasian and Asian people, and athletes, gymnasts or dancers who are very thin, particularly if their menstruation has stopped.
Factors that increase the risk
Factors that increase the risk of osteoporosis include the following.
- Low bone mineral density.
- A previous fracture resulting from a low-trauma incident, such as a small fall (as opposed to falling down a flight of stairs).
- Increasing age.
- Female gender.
- Family history, particularly parents who ‘lost height’ in older age, developed a humped back or had a hip fracture.
- Cigarette smoking.
- Being less than 60 kg in weight.
- A low calcium diet.
- Inactivity.
- Chronic disease.
Some medical conditions and medicines predispose people to secondary osteoporosis. These include:
- long-term or frequent use of prednisone;
- some anti-convulsant medicines; and
- hyperthyroidism.
What can you do to help?
You should aim to prevent osteoporosis by modifying your lifestyle while you are still young. Bones stop growing in the early 20s, but continued calcium intake and a healthy lifestyle are important to maintain bone mass. Bone calcium loss increases markedly from about 50 years onwards, although lifestyle and adequate calcium intake helps reduce the loss.
For these reasons you should stop smoking, avoid excessive alcohol, undertake weight-bearing exercise, and ensure that your diet contains enough calcium.
Last Reviewed: 11 June 2002
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