Breaking point
OSTEOPOROSIS is clinically defi ned as a skeletal disorder in which the bones become increasingly porous, brittle, and fragile due to hormonal changes or a deficiency in calcium and vitamin D. The general weakening of bones causes them to break easily from any low-trauma incident, such as falls and slips, and in more serious cases, from bending or minor bumps.
“The most important thing, if you have osteoporosis, is to not fall,” Dr. Monica Therese Cating- Cabral, head of St. Luke’s Medical Center-Bonifacio Global City’s Osteoporosis and Metabolic Bone Disease Service, told BusinessWorld in an interview. “The disease itself isn’t fatal, but when you develop a fracture, there’s increased risk for complications and there’s increased risk for dying sooner because of those complications.”
Osteoporosis affects around 200 million women worldwide and, in the Philippines, afflicts about 33% of Filipino women over 50 years old. But Dr. Cabral pointed out that while the condition is more prevalent among menopausal women, andropausal men can have it, too. According to her, one in four women and one in five men are likely to develop osteoporotic fractures as they age.
“It’s a silent disease, so you don’t really know you have it unless you get yourself checked, or until you fall and break something. Most young people, or people below 50, when they fall they usually fall forward and they soften the impact of the fall with their arms. But as you get older, you don’t act as fast and you usually fall on your [ behind]. Most of the patients thus develop hip fractures, but you can also have fractures on your spine and on your wrists,” she explained. “It can happen anywhere, actually, but when we test for osteoporosis, these are usually the areas that we check.”
She said that even though not everyone will develop osteoporosis, it remains a common disease and there are a lot of risk factors involved, such as family history, race, previous injuries, lifestyle choices (such as smoking or drinking too much alcohol), and certain types of medication. Any preventive measures, she said, should have started in childhood.
“It’s like putting money in a bank,” Dr. Cabral said. “If you’ve had strong bones since you were a kid, then you’ll likely have strong bones when you’re an adult. We develop our bones as we grow and get enough nutrients. All these will build up your bones until your early 30s, which is when you achieve what we call peak bone mass. It’s when your bones are the strongest, and that’s the strongest they’ll ever be.”
She said that exercising, as well as consuming enough calcium and vitamin D, are among the ways to keep bones healthy throughout the growing period. Bone mass gradually starts to decline at the age of 35, so she said people who weren’t able to build good bones earlier in life won’t have as much to rely on as they grow older. She believes that upon reaching 50, people should be tested for osteoporosis every year, especially if they identify with a number of risk factors.
A bone mineral density test is the primary tool used to diagnose osteoporosis in a patient. It is a whole- body test that measures the amount of calcium and other types of minerals in the bones. When a person gets diagnosed with the condition, Dr. Cabral said there are several treatment options available, depending on the severity of the disease.
New types of medication are also being developed, and she said that one of the notable facts about these new treatments is that they can be taken even by patients who have kidney problems.
“[But] prevention is still key,” she said. “If you’re already too old to build strong bones, and you have or are at risk of having osteoporosis, be extra careful. Make sure you walk in well-lit areas, use a cane if you need one, and be very mindful of your surroundings.”