Core tips: the elderly group to the twilight of the age, the movement began to be less sharp, back pain began to haunt the leg pain, some people began to become shorter in height, even by a little force will fracture, all of these symptoms are hinted at osteoporosis is not far from you. 70 million osteoporosis patients, middle-aged and elderly urgently need to prevent China currently has 70 million people suffering from osteoporosis, of which 1 in 3 women and 1 in 5 men over the age of 50 may suffer from osteoporotic fractures. It has become another common disease of the elderly after hypertension. So why does osteoporosis occur? What causes so many older adults to develop osteoporosis? As we age, there is a parabolic trend in bone mass. Between the ages of 28-35, a peak in bone mass occurs, after which a downward trend begins, and the incidence of osteoporosis increases when people reach the age of 60 or older and after women go through menopause.” The reason for this change is that the maintenance of bone mass depends on the balance of osteoblast and osteoclast functions in the body. Before the age of 35, osteogenesis is greater than osteolysis and bone mass increases, after which the two are in balance and bone mass is stable, and after old age and menopause in women, with the decrease in endocrine function and estrogen levels, osteolysis is greater than osteogenesis, bone mass decreases and osteoporosis quietly occurs. Sudden cramps, muscle pain, short height precursors of osteoporosis In life, it is common for the elderly to fall easily, thinking that it is caused by inflexible legs and feet, but in fact, it is caused by osteoporosis. Unlike young people, a small fall may cause fractures, including fractures of the thoracic and lumbar vertebrae, hip and distal forearm. Vertebral fractures can lead to decreased quality of life, loss of appetite and lung function, sleep disorders, and shorter life expectancy. Half of the patients with hip fractures will have difficulty moving and will need to be cared for. Severe fractures can cause paralysis. Some more severe osteoporosis may result in a rib fracture from just a sneeze or cough. ”Osteoporosis is not taken seriously because it is asymptomatic or mild in its early stages, and by the time a fracture occurs the osteoporosis has often been long in the making.” Older adults often experience cramps, back pain, hunchback and short stature, but many don’t care because they think it’s a normal part of aging. ”The most correct iteration is for middle-aged and older adults to go to the hospital for a bone density test to determine if they have osteoporosis. Middle-aged and older adults can go to the hospital for a bone density test to determine if they have osteoporosis, especially if they have had a fracture, have used oral steroid hormones for more than 3 months, are thin, have early menopause, have inadequate calcium intake, have chronic diarrhea, have parents with osteoporosis, have middle-aged and elderly people who lack exercise, smoke and drink a lot of alcohol and coffee.” Once diagnosed, fractures can be prevented through treatment under medical supervision. The former is easy to perform, but slightly less accurate and can be used as a physical screening test; the latter has the highest credibility and is the gold standard for determining bone density. In our clinic, many osteoporosis patients think that taking calcium tablets alone can cure osteoporosis, which is wrong. Calcium tablets and vitamin D alone are only basic treatment, which is not enough for patients who already suffer from significant osteoporosis, but also requires medication, which generally includes drugs that inhibit bone resorption such as (bisphosphonates, SERMS, calcitonin, estrogen) and drugs that promote bone formation (fluoride preparations, PTH). The minimum course of treatment requires one year to observe the efficacy. Therefore, patients need to be patient and cooperative. At the same time, patients are warned that taking calcium tablets can easily lead to overdose and osteoporosis, and it is best for the elderly to meet their calcium needs through a balanced diet. Besides being influenced by uncontrollable factors such as heredity, there are some controllable high-risk factors for osteoporosis: including smoking, alcoholism, taking hormonal drugs, early menopause (before the age of 42), people who have had their ovaries cut off, low body weight, low sex hormones, excessive consumption of coffee and carbonated drinks, lack of physical activity, and insufficient calcium intake. People with these high-risk factors should pay special attention to adjusting their lifestyle and exercising more. Secondly, food intake is an important aspect, including eating mushrooms, cod liver oil, etc., but this only accounts for about 10% of the body’s needs; the remaining 90% depends on its own skin synthesis. Regular participation in outdoor activities and proper exposure to sunlight can effectively reduce the incidence of osteoporosis and make the spine more rigid. Sunbathing and outdoor activities have the effect of both treating osteoporosis and preventing its occurrence. Sunbathing exposes more than 40% of the skin, and applying sunscreen and umbrellas are ineffective. Some elderly people like to walk in the morning and evening, when the sun’s energy is very low, especially in winter, it is recommended that the elderly activities time to 9-10 a.m., 2-5 p.m. is better. In addition to more sunlight and dietary supplements, many elderly people’s metabolism is basically in a negative equilibrium stage, and the ability to convert vitamin D is gradually decreasing. At this time, elderly people should supplement active vitamin D, which does not require human metabolism, under the guidance of a doctor to promote calcium absorption.