Regular check-ups after 60, bone assessments, exercises and preventive measures to break falls can go a long way in helping seniors
October 20 was World Osteoporosis Day (WOD). It aims to make osteoporosis and fracture prevention a global health priority by reaching out to health-care professionals, the media, policy makers, patients, and the public at large.
But what exactly is osteoporosis? Let me explain with an example.
Recently, I had a casual dinner table conversation with my flat-mate, who is an orthopaedic surgeon, who told me about a 78-year-old gentleman who had presented himself at the hospital with a fractured hip.
He could not be operated upon because he had multiple co-morbidities. His case was deferred, awaiting further clearance from the anaesthetist. The gentleman had a trivial trauma to his hip, sustained during a fall on the slippery surface of his washroom.
Now, this fall would certainly not have caused a fracture in a younger person with stronger bones. With old age though, bones become weaker and brittle, and are susceptible to breaking with trivial force. Such a condition is known as ‘senile osteoporosis’.
Osteoporosis is relatively a symptomless condition with the patient feeling no urgency to seek a physician’s consultation, till it resurfaces as it happened with the above-mentioned 78-year-old gentleman.
An epidemiological study done in Delhi suggests that 24 per cent of men and 42 per cent of women above the age of 50 years have osteoporosis.
With such a high prevalence of osteoporosis, orthopedic emergencies are choc-a-bloc with old age patients presenting with broken bones after a trivial trauma (at times a violent sneeze is enough).
We need to put the old saying, “prevention is better than cure”, into practice. Osteoporosis assessment through a yearly bone densitometry after 60 years, comes in handy to indicate the fracture risk of an individual.
The geriatric physician may then start treating the condition accordingly. A variety of drugs can be started by the physician to improve the bone health.
Patients are encouraged to maintain a moderately active lifestyle. Daily morning walks, lifting small amount of weights along with the medications improves bone density. A calcium-rich diet, which at times is supplemented by oral calcium and vitamin D tablets, is essential too.
I want to focus on an often neglected component of osteoporosis management which is, “fall prevention”. Fall prevention seeks to improve the body balance by a variety of exercises and activities.
The National Osteoporosis Foundation recommends Tai Chi, a Chinese martial art form to improve body balance. The home architecture should be geriatric-friendly.
The house should be brightly lit, the floor of the washroom should be non-slippery and provided with grab bars and chains. A vision assessment should be done and the person should be provided with a spectacles if needed.
Nirmalya Mohapatra is Senior Resident, Department of Physical Medicine and Rehabilitation, Dr. Ram Manohar Lohia Hospital, New Delhi
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