Core Tip: Human bone mass peaks around the age of 30 and begins to decrease between the ages of 40 and 50. Many factors can have an impact on it, such as genetics, environment, nutrition, exercise, lifestyle, hormone levels, etc.
Osteoporosis is a systemic disease characterized by a generalized decrease in bone mass and destruction of the microstructure of bone tissue, resulting in increased bone fragility, reduced bone strength and susceptibility to fracture.
Human bone mass peaks around the age of 30 and begins to decrease between the ages of 40 and 50. Many factors can influence it, such as genetics, environment, nutrition, exercise, lifestyle, hormone levels, etc.
After people enter old age, gonadal function decreases and secretion decreases; food intake becomes smaller, calcium intake is less; outdoor activities are less, sunshine time is shortened, vitamin D synthesis is insufficient; lack of exercise, blood circulation in the bones is reduced, calcium in the bones is easily absorbed and moved out of the bone; organs are degenerative changes, organic disorders increase; slow movement, slow reaction, vision and hearing loss, the chance of injury increases. These are the reasons why the elderly are prone to osteoporotic fractures.
Risk factors for osteoporosis.
(1) Age, people over 65 years old.
(2) Genetics, Caucasians are more susceptible than yellows, who are in turn more susceptible than blacks, and those with a family history of osteoporosis.
(3) Diet, long-term low-calcium diet, lack of nutrition.
(4) wasting, the incidence of osteoporosis is high in people with low body mass index.
(5) Postmenopausal women or premature amenorrhea and women with declining estrogen due to ovariectomy.
(6) People with habits such as alcoholism, heavy smoking, long-term coffee and strong tea.
(7) Drugs, long-term use of corticosteroids, barbiturates, dalentin, heparin, etc.
(8) Diseases, endocrine diseases, nutritional metabolic diseases, renal insufficiency, rheumatoid arthritis, severe liver disease, etc.
(9) Weightlessness, such as astronauts.
(10) Lack of exercise, such as people who are bedridden for a long time.
How to diagnose osteoporosis
The more common symptoms of osteoporosis are.
(1) Pain, with low back pain more common.
(2) Hunchback and shortening of body length.
(3) Fractures, which can occur when coughing, sneezing, laughing, bending over to pick up a child, bending over to pick up something, or turning around. The most common sites for osteoporosis fractures are the hip, vertebrae, and wrist.
Patients with osteoporosis can also be asymptomatic in the early stages, and the medical community refers to it as a quiet epidemic. The diagnosis of osteoporosis in the elderly is based on a comprehensive evaluation of several aspects, including medical history, bone densitometry, biochemical tests, imaging tests, and bone biopsy. Dual-energy X-ray bone densitometry is currently the gold standard for the diagnosis of osteoporosis and the observation of the efficacy of preventive and curative measures at home and abroad. 1994, the World Health Organization used this test result to establish the diagnostic criteria for osteoporosis in white women, which is still applied in most countries in the world. Biochemical tests of bone metabolism provide a rapid, dynamic picture of the overall rate of bone rebuilding and can predict the rate of bone loss. Imaging tests, including X-rays, CT, quantitative CT, quantitative ultrasound, and MRI, are also very useful tests.
Osteoporosis typing: Osteoporosis is divided into primary osteoporosis and secondary osteoporosis. Primary osteoporosis accounts for about 90% of the total number of patients, and it is subdivided into type I (postmenopausal osteoporosis) and type II (senile osteoporosis). Secondary osteoporosis accounts for about 10% of the total number of patients and is often caused by various endocrine, renal and digestive system diseases and improper medication and disuse.
How to detect osteoporosis early
Patients with osteoporosis often have no obvious symptoms in the early stage. People should start to pay attention and be alert when they have the following symptoms: they start to feel weak and painful in their lower back when walking or moving their body, which gradually becomes chronic pain and occasionally sudden severe pain; their back gradually bends and their height becomes shorter. People with risk factors for osteoporosis should have their bone density checked in time, and even if it is normal, attention should be paid to prevention.
How to prevent and treat osteoporosis
The prevention of osteoporosis must focus on people at high risk of osteoporosis, including people with reduced bone mass or spinal deformities on X-ray, menopausal women and the elderly, people with reduced height and hunchback, people who are bedridden for a long time, people with insufficient vitamin D and calcium intake, people who have had their ovaries, uterus, stomach or small intestine removed, people with low back pain or hip fractures, people with a family history of osteoporosis, people who have been taking corticosteroids, anti-spasmodic drugs, diuretics, etc. for a long time. anti-spasmodics, diuretics, stomach medications, painkillers and other drugs, people with long-term addiction to smoking and alcohol, people with chronic abnormal functional diseases related to osteoporosis, such as hyperthyroidism, hyperparathyroidism, renal failure, liver disease, people with body mass index (BMI) less than 19 kg/m2, etc.
Calcium and vitamin D are the basic medications for the prevention and treatment of osteoporosis. In general, the basic preventive treatment for osteoporosis is 1200 mg of calcium and 800 units of vitamin D. For patients with a clear diagnosis of osteoporosis, it is not enough to give calcium and vitamin D treatment alone; an individualized drug combination regimen should be chosen under the guidance of a specialist, depending on the patient.
There are two main categories of drugs for the treatment of osteoporosis: those that inhibit bone resorption and those that promote bone formation. Drugs that inhibit bone resorption include estrogen, estrogen receptor modulators, diphosphonates, calcitonin, etc. Drugs that promote bone formation include fluoride, parathyroid hormone, growth hormone, strontium salts, etc.
For adults, increased exercise can reduce bone loss to preserve bone mass, and exercise can increase muscle strength and coordination of movement, which is important to prevent falls and fractures in the elderly.