Management of Osteoporosis

Introduction

Osteoporosis is one of the major health conditions that increase the risk of disability and poor quality of life among the elderly, especially postmenopausal women. Apart from hormonal deficiency, immobilization of limbs due to increased sedentary lifestyle also contribute to the decrease of bone density thereby culminating in heightened osteoporosis among the at-risk group. Even though a variety of therapeutic measures have been proposed to curb the progression of osteoporosis, dieting and exercises, as well as patient education, remain the most effective strategy for managing the condition.

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Background Information

According to the Centers for Disease Control and Prevention (CDC) (2011a), about 2% of men (0.8 million) in the United States have osteoporosis. The disease is more prevalent in women, standing at 10% (4.5 million). Based on the Merck Manual of Medical Information, osteoporosis is defined as “a condition in which a progressive decrease in the density of bones weakens the bones, making fractures likely” (Raisz, 2008, para.1). A number of factors can contribute to a decrease in bone density. For instance, the constituents for density and strength of bones can be decreased by certain disorders, aging, and deficiency of calcium, vitamin D, and estrogen. The condition progresses slowly hence notable in late adulthood (National Institutes of Health, 2011a, paras. 1-3).

There are two common categories of osteoporosis: primary and secondary osteoporosis. Primary osteoporosis is spontaneous while secondary osteoporosis may result from the effect of medication (such as barbiturates) or as a comorbid condition. Primary osteoporosis is the most prevalent and affects most women in the postmenopausal period due to the insufficiency of estrogen. On the other hand, secondary osteoporosis may be associated with other conditions such as diabetes and kidney disease. The condition can also be exacerbated by smoking and alcohol consumption (Raisz, 2008, para.6).

In occasional cases, some individuals even in their childhood may develop idiopathic osteoporosis whose causes are largely unknown. Being of Asian or white descent and leading a sedentary life are also factors that put women at risk for developing osteoporosis (Raisz, 2008, para.11).

Symptoms

Symptoms of osteoporosis develop progressively leading to excruciating pain from collapsed or fractured bone. Chronic back pain in women of postmenopausal age may be linked to collapsed vertebrae. Osteoporosis may also affect wrist and hip bones which take longer to heal hence leading to disability in elderly people (Raisz, 2008, para.12).

Diagnosis

Women aged 50 and above are at risk of developing osteoporosis. Other signs that may aid in the diagnosis of osteoporosis include inexplicable back pain in individuals above the age of 65 years, patients with thinner bone x-ray, and adults with a history of osteoporotic bone collapse or fissure (Raisz, 2008, paras.16-17). Suspects of osteoporosis can be confirmed or detected test on bone density before fracture. Commonly, bone density is measured by dual-energy x-ray absorptiometry (DEXA). Also, the levels of vitamin D and calcium can be measured through a blood test (Raisz, 2008, paras.16-17).

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Section of bone showing osteoporosis

Diet and Exercise in the Management of Osteoporosis

As aforementioned in the Merck Manual, osteoporosis is a condition marked by a decrease in bone density. There are many pharmaceutical companies that come up with drugs that claim to cure osteoporosis. As noted in the article, The Marketing of Osteoporosis by Maryann Napoli in the American Journal of Nursing, these drugs are purely for commercial gain. According to Napoli (2009), a number of people only lookout for treatment for predisposing factors such increase in cholesterol level or decrease in bone density rather than finding treatment for the underlying ailment. Thus, it is obvious that pharmaceutical companies contribute to the overestimation of such risk factors to enroll patients in enduring drug treatment. (p.58).

As shown by the author the perception that osteoporosis is a disease rather than a risk factor marked by the decrease in bone loss is mainly propagated by drug companies. As such, to prevent the occurrence of the condition, many women are encouraged to seek diagnosis and take medications. Further, Napoli explains, since the advent of osteoporosis medications, ironically, younger women, contrary to the elderly have become the target of pharmaceutical companies (Napoli, 2009). It has been noted that numerous advertisements are featuring young women who are warned of an impending risk of osteoporosis if they do not embark on early screening and management of the condition. Napoli (2009) vehemently campaigned against such advertisements with unproven benefits.

Due to such campaigns, physicians have been urged to stop early bone density scans for women under the age of 65 as recommended in the Agency for Healthcare Research and Quality guidelines enacted in 2002. Also, pharmaceutical companies have turned to depict women above the age of 60 in their advertisements.

Therefore, a diet rich in calcium and vitamin D and involvement in physical activity provides the most efficacious treatment and prevention of osteoporosis. CDC provides a guideline of calcium intake as recommended by the National Academy of Science. For individuals aged between 51 and 70 daily intakes of calcium should be 1200 grams. Also, adults should participate in at least an hour of average physical exercise every day (CDC, 2011b, paras. 6 and 9).

Recommended Calcium Intakes

Ages Amount mg/day
Birth–6 months 210
6 months–1 year 270
1–3 500
4–8 800
9–13 1300
14–18 1300
19–30 1000
31–50 1000
51–70 1200
70 or older 1200
Pregnant & Lactating 1000
14–18 1300
19–50 1000

Apart from calcium, patients with osteoporosis can also benefit from diet rich in vitamin D. The table below indicates the indicated daily intake for vitamin. However, higher vitamin A intake may be detrimental to the bones (National Institute of Heath, 2011b).

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Recommended Vitamin A Intakes

Age (yrs) Children Men Women Pregnancy Lactation
1 to 3 1,000
4 to 8 1,333
9 to 13 2,000
14 to 18 3,000 2,330 2,500 4,000
19+ 3,000 2,330 2,565 4,335

Conclusion

Osteoporosis remains a challenge to the elderly individuals, especial women in the United States. Several drugs marketed by pharmaceutical companies are not efficacious against osteoporosis. It is therefore important to educate the public on the benefits of diet rich in calcium and vitamin D and involvement in daily physical activity.

Reference List

Centers for Disease Control and Prevention (CDC). (2011a). FastStats: Osteoporosis. Web.

This article provides the prevalence of osteoporosis in the United States. It indicates that the condition is more common among older women compared to men of similar age bracket. The article thus forms and important source for developing the background of the paper.

Centers for Disease Control and Prevention (CDC). (2011b). Calcium and Bone Health. Web.

This article outlines the recommended daily intake of calcium. It also emphasizes on the intake of vitamin D and involvement in exercise as strategies for managing osteoporosis.

Napoli, M. (2009). The Marketing of Osteoporosis. American Journal of Nursing, 109(4): 58–61. Web.

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This is a peer reviewed journal article. Napoli provides an in-depth criticism of the drug companies that are out to make profit by claiming to make profit from drugs that are believed to prevent osteoporosis. The article is an educative source for women and policymakers who need to promote diet and exercise as the most efficacious strategy.

National Institutes of Health. (2011a, Nov 18). Osteoporosis. Web.

This is a page of the government. It explores the risk factors for osteoporosis.

National Institute of Heath. (2011b). “Vitamin A and Bone Health.” Osteoporosis and Related Bone Diseases National Resource Center. Web.

This is a page of the government. It explains the recommended daily intake for vitamin A. It also shows the importance and risk of consuming higher doses of vitamin.

Raisz, L.G. (2008). The Merck’s Manual Home Health Handbook: Osteoporosis. New Jersey, N.J.: Merck Sharp & Dohme Corp. Web.

Raisz also explains the risk factors for osteoporosis apart from giving and in-depth description of categories, diagnosis, symptoms, and treatment of osteoporosis. This manual has recent updates on osteoporosis.

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