Osteoporosis is a prevalent skeletal disorder characterised by reduced bone mass and diminished bone tissue quality, resulting in bone fragility and an increased susceptibility to fractures. This condition is particularly significant in older individuals, affecting both men and women, although it is more prevalent in postmenopausal women. Understanding the causes, symptoms, and management of osteoporosis in older people is crucial for effective prevention, diagnosis, and treatment.


Causes Of Osteoporosis In Older People


Dr Chandra Sekhar Dannana, who is a Senior Consultant - Orthopaedics, at CARE Hospitals Banjara Hills, Hyderabad said the following causes and symptoms for osteoporosis:


Ageing and Bone Density: Ageing is a primary factor in the development of osteoporosis. Bone density naturally decreases as individuals age, especially after the age of 50. This decrease in bone density is more pronounced in women after menopause due to a decline in oestrogen levels. In men, a gradual reduction in testosterone levels as they age contributes to bone loss, albeit at a slower rate than in women. The decline in bone density with age increases the risk of osteoporosis and fractures.


Hormonal Changes: Hormonal changes play a crucial role in the development of osteoporosis, particularly in postmenopausal women. Estrogen, a hormone that helps maintain bone density, declines significantly after menopause. The abrupt reduction in estrogen levels accelerates bone loss, particularly from the trabecular bone, which is the spongy, inner part of the bone. Similarly, in older men, the decline in testosterone levels contributes to reduced bone density and an increased risk of osteoporosis.


Dietary Factors: Adequate nutrition, especially in terms of calcium and vitamin D intake, is essential for maintaining optimal bone health. Calcium is a vital mineral for bone strength and density, and a deficiency over time can lead to weakened bones. Vitamin D is crucial for calcium absorption in the body, and inadequate levels can impair the body's ability to absorb calcium efficiently. A lifetime of insufficient calcium and vitamin D intake can contribute to lower bone density, making bones more susceptible to osteoporosis.


Lifestyle Choices: Lifestyle factors significantly influence bone health and osteoporosis risk in older individuals:



  • Physical Inactivity: Lack of physical activity and weight-bearing exercises can lead to weaker bones over time. Weight-bearing exercises, such as walking, jogging, and weightlifting, help maintain bone density and strength.

  • Smoking: Smoking is linked to a decrease in bone mass and can accelerate bone loss. Additionally, smoking can hinder the healing of fractures.

  • Alcohol Consumption: Excessive alcohol consumption can decrease bone mass and interfere with the body's ability to absorb calcium, contributing to osteoporosis.

  • Caffeine Intake: High consumption of caffeine may interfere with calcium absorption, potentially affecting bone health over time.


Medical Conditions and Medications: Certain medical conditions and medications can increase the risk of developing osteoporosis:



  • Medical Conditions: Chronic conditions like celiac disease, Crohn's disease, rheumatoid arthritis, and hyperthyroidism can interfere with calcium absorption or affect bone health, potentially leading to osteoporosis.

  • Medications: Prolonged use of corticosteroids, which are commonly prescribed for inflammatory conditions, can significantly decrease bone density and increase the risk of fractures. Other medications, such as some antacids containing aluminium and specific anticonvulsant drugs, can also contribute to bone loss.


Symptoms of Osteoporosis In Older People:


Early stages of osteoporosis often do not manifest noticeable symptoms. As the disease progresses, individuals may experience the following symptoms mentioned by Dr Chandra Sekhar Dannana.



  • Bone Fractures: Osteoporosis weakens bones, making them more susceptible to fractures. Common fracture sites include the spine (vertebral compression fractures), hips, wrists, and other bones. Fractures can occur from minor incidents, like a fall or even minor trauma, leading to fractures that may have significant consequences for an individual's mobility and quality of life.

  • Height Loss and Altered Posture: Vertebral compression fractures, which are common in osteoporosis, can result in a gradual loss of height and changes in posture. The vertebrae may collapse, causing the spine to curve and resulting in a stooped or hunched appearance.

  • Back Pain: Compression fractures in the spine can cause acute and sharp back pain. This pain can be sudden and severe, indicating a potential vertebral fracture due to osteoporosis.

  • Bone Fragility and Weakness: People with osteoporosis may notice that their bones are more fragile and prone to fractures. Simple actions like lifting heavy objects or even minor falls can result in broken bones.

  • Restricted Mobility and Activity: Fractures and weakened bones can restrict mobility and daily activities. Individuals with osteoporosis may experience limitations in their ability to perform routine tasks, impacting their independence and overall quality of life.

  • Impact on Quality of Life: Chronic pain, a decrease in mobility, loss of independence due to fractures, and the constant fear of experiencing fractures can significantly impact an individual's overall quality of life. Osteoporosis can affect not only physical health but also mental and emotional well-being.


Management And Prevention Of Osteoporosis In Older People


Lifestyle Modifications:



  • Balanced Diet: Ensure a diet rich in calcium, vitamin D, and other essential nutrients for bone health. Dairy products, leafy greens, nuts, and fortified foods are good sources of calcium and vitamin D.

  • Regular Exercise: Engage in weight-bearing exercises like walking, jogging, dancing, and strength training to enhance bone density and strength.

  • Avoid Smoking and Excessive Alcohol: Quit smoking and limit alcohol consumption to reduce the risk of osteoporosis and bone fractures.

  • Monitor Caffeine Intake: Be mindful of caffeine consumption and moderate its intake to promote optimal calcium absorption.


Medical Intervention:



  • Bone Density Testing: Regular bone density tests (e.g., DEXA scans) can assess bone health and help in the early detection and monitoring of osteoporosis.

  • Medications: Depending on the individual's risk factors and bone health, healthcare professionals may prescribe medications to slow bone loss or promote bone growth.

  • Supplements: Calcium and vitamin D supplements may be recommended if dietary intake is inadequate.

  • Hormone Replacement Therapy (HRT): In postmenopausal women, hormone replacement therapy may be considered to help maintain bone density. However, the risks and benefits should be carefully evaluated.


Ongoing Monitoring and Care: Regular follow-ups with healthcare professionals, adherence to prescribed treatments, and maintaining a healthy lifestyle are essential components of managing and preventing osteoporosis in older adults.


Tips To Manage Osteoporosis In Old Age:


Dr. Milind Patil, who is the Director of Revival Bone & Joint Hospital, Thane said, "Managing osteoporosis in older people involves a combination of strategies. The aim is to make bones stronger, reduce the risk of falls, relieve symptoms, and maintain functionality. Some medications, like calcium supplements, vitamin D, and others, can improve bone density. But remember, these medications should only be used if their benefits outweigh the risks."


He further went on to say the following:



  • Incorporating regular weight-bearing and muscle-strengthening exercises is crucial, particularly in older age. Walking, dancing, low-impact aerobics, elliptical training machines, stair climbing and gardening work directly on bones in the legs, hips and lower spine to slow bone loss.

  • Older individuals should also focus on maintaining a healthy body weight. Excess weight can increase the risk of fractures, so it's essential to strike a balance between weight management and muscle mass preservation through diet and exercise.

  • Other than that, hormonal changes, often associated with menopause or thyroid problems, can impact bone health. It's vital to address these imbalances.

  • As people age, they become more vulnerable to osteoporosis, a condition characterized by weakened bones. While screening the entire population for osteoporosis can be costly and less accurate, it's advisable for menopausal women and high-risk elderly individuals to have their bone density checked when possible as prevention is the key.

  • Raising awareness about the importance of bone health, especially in the elderly, is essential.


How To Manage Osteoporosis With Arthritis?


Dr. Mukesh Batra, who is the Founder and Chairman, of Dr Batra’s Healthcare said, "Treating osteoporosis and arthritis can be difficult, as these are two separate yet occasionally intersecting illnesses. It is important for people who are diagnosed with osteoporosis and arthritis to engage in regular exercise to improve joint flexibility, muscle strength, and balance. Weight-bearing exercises can also help strengthen bones."


"Homoeopathic medicines are alternative treatments for healing weak bones and the issues that can arise as a result of them. To maintain bone health, adopt a diet that is high in calcium and vitamin D. These essential vitamins and minerals are abundant in dairy products, leafy greens, and enriched foods. Always prioritize your safety and well-being by seeking adequate medical attention and following the advice of a qualified homoeopath," he added.


[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]