This morning, a friend called me, his father did not hold steady when he got up in the morning, fell off the bed, and now the back pain is very strong, asked me what to do, “first come to the hospital to take a film,” take a look at the film, and indeed the unfortunate thing still happened, the old man lumbar compression fracture.
”Just a little fall, how also fractured?”
To answer this question, we have to start at the beginning – osteoporosis
Strictly speaking, there are many kinds of osteoporosis, but the most common is primary osteoporosis, which is also the main content of this discussion.
”In 2016, the prevalence of osteoporosis in Chinese people over 60 years of age was 36%, including 23% in men and 49% in women, and the most serious consequence of osteoporosis is osteoporotic fracture. According to epidemiological surveys, in 2010, China had 2.33 million patients with osteoporotic fractures, including 360,000 hip fractures, 1.11 million vertebral fractures and 860,000 other osteoporotic fractures, for which the medical expenditure was 64.9 billion yuan” – China’s osteoporosis diagnosis and treatment guidelines for the elderly (2018)
Yes, osteoporosis most often causes not only vertebral fractures, but also hip fractures, distal radius fractures, etc. In medicine, these fractures have a very visual term “fragility fractures”
Therefore, osteoporosis is a common disease among the elderly, and by the time a fragility fracture occurs, the osteoporosis is often already very serious.
So, how can we deal with this disease?
First of all, we need to determine the question, how old is an elderly person?
In 1996, the United Nations clearly proposed that the elderly population aged 60-79 years old is called “Youngerelderly”, and those aged 80 years old and above are called “Olderold” ( Theoldestold). The Chinese Society of Gerontology and Geriatrics defines 60 years as the age of the elderly population, therefore, when the age is over 60 years, it is necessary to be alert to the occurrence of osteoporosis, especially in women during the perimenopause and within 10 years after menopause, there is often a rapid loss of bone mass, and systematic anti-osteoporosis treatment is often needed at this time.
Do all older people suffer from osteoporosis?
Of course not.
Older people with reduced function of various organs, reduced bone metabolism and insufficient osteogenesis are prone to osteoporosis, especially in the elderly, where the intake as well as absorption of various nutrients have declined, a condition that mostly requires medication while living a healthy life.
Especially when these conditions occur, you need to be alert to osteoporosis.
Some patients with osteoporosis have no obvious symptoms, so the most important thing is to remember to measure bone density regularly when you reach a certain age.
Low back pain, difficult to pinpoint where the pain is, relieved by activity, but aggravated by too much activity and weight-bearing.
Hunchback, height reduction, height can be shortened up to 3-6cm in elderly people with osteoporosis, and can even lead to breathing difficulties in severe hunchback.
So, how to prevent and treat osteoporosis?
Calcium and Vitamin D
The main component of bone is calcium, so adequate calcium and vitamin D are essential for the prevention and treatment of osteoporosis.
The recommended daily intake of calcium is 1000-1200 mg (1000 mg/d for men aged 50-70 years; 1200 mg/d for women aged ≥51 years and men aged ≥71 years).
sex and ≥71 years old men), and elderly people often have vitamin D deficiency due to lack of sunlight and impaired intake and absorption, and the recommended daily intake of vitamin D is 800~1200 IU/d.
The recommended daily intake of vitamin D is 800 to 1200 IU/d. Calcium D, which is commonly available on the market today, is a drug that uses calcium and vitamin D together. However, it is best to achieve calcium and vitamin D intake through diet if possible.
Active vitamin D
Vitamin D absorbed by the body needs to be “1α-hydroxylated” in the kidneys to form active vitamin D in order to exert its anti-osteoporosis effect, so active vitamin D and its analogs do not require kidney activation to be active. The main drugs of this class currently on the market are alpha-osteolysis, osteotriol, etc.
Bisphosphonates
These drugs can inhibit bone resorption, so as to achieve the effect of anti-osteoporosis, currently commonly used are alendronate sodium, zoledronic acid, etc. Generally, after 5 years of oral bisphosphonates or 3 years of intravenous zoledronic acid, it is necessary to review the bone density and decide whether to use the drug.
In conclusion, treatment of osteoporosis is a long-term process, healthy living, diet and medication are important.