Osteoporosis is a 'silent killer' for the elderly

 

Do you know what "osteoporosis" is? Do you know the risks of osteoporosis?

I think you should know that old people should take calcium supplements and bask in the sun, but blind calcium supplements and symbolic stay in the sun for a while every day can really prevent osteoporosis?

How many people really understand this disease and effectively prevent it? I don't think there are many of them. Because --

According to the survey, osteoporosis has become an important health problem in China's middle-aged and elderly people, the prevalence of osteoporosis in people over 50 years old is 19.2%, of which the prevalence of women is 32.1%, and the prevalence of men is 6.0%.

 

(I)What is osteoporosis?

I'm going to show you a picture of healthy bone and loose bone. Loose bones are like a tree trunk eaten by worms, strong outside, dry, vulnerable, a gentle fall may break.

Concept: Therefore, osteoporosis is a systemic bone disease characterized by low bone mass, damage to the microstructure of bone tissue, resulting in increased bone fragility and prone to fracture.

(2)Why does osteoporosis occur?

There are several causes (osteoporosis is classified as primary and secondary)

(1)   Not eating enough:"People are iron, rice is steel", many elderly people, the diet is too light, do not pay attention to the balanced intake of nutrition, so that the intake of raw materials for synthetic bone is insufficient, especially the intake of calcium is insufficient, so that osteoblasts can not synthesize more bone.

(2)   Poor absorption:Bone formation requires not only calcium, but also other raw materials such as vitamin D, vitamin C, polysaccharides, proteins, and so on. If your gut absorption function is not good, it will lead to a lack of the above raw materials, and it will not be able to synthesize more bone.

(3)   Too little exercise:We have osteoblasts in our bodies, and we also have osteoclasts, and this osteoclast, which is a bad guy, eats bone, like a bug that eats trees, and destroys our bones, in a process called bone resorption. If they have little activity in daily life, muscle atrophy, or long-term bed rest, then the mechanical stimulation of the bone will be weakened, at this time, the osteoclast this "borer" is active, bone absorption is enhanced, and osteoporosis is accelerated.

(4)   Less sun exposure:Light indoor exercise is not enough, we all know that calcium deficiency to supplement vitamin D, and the sun can synthesize vitamin D, but the so-called "easy to do" to do very little, and master the correct way to bask in the sun not many people.

(5)   Hormone levels have droppedEstrogen can promote the formation of osteoblasts and promote the apoptosis of osteoclasts. When women are postmenopausal, estrogen shows a cliff-like decline, osteoclasts are active, bone loss is accelerated, and osteoporosis is easy to occur. Therefore, in China, women's osteoporosis is about 5 times that of men. So female friends must pay more attention to their bone health.

(6)   Whether you smoke or drink alcoholSmoking will lead to the increase of osteoclasts, while drinking will damage the absorption function of the gastrointestinal tract, resulting in the absorption of bone synthesis raw materials, and alcohol can fight osteoblasts, resulting in a decrease in bone synthesis.

(3)Come and see if the list of osteoporosis risk groups has you figure

(1)   Women over 50 years of age and men over 65 years of age with unexplained chronic low back pain ;

(2)   45Women after natural menopause or bilateral oophorectomy before age;

(3)   Various causes of low sex hormone levels in adults;

(4)   Adults with a family history of fragility fractures;

(5)   There are multiple risk factors for osteoporosis, such as old age, smoking, braking, long-term bed rest, etc

(6)   Patients with the following history: Diseases affecting bone metabolism include various endocrine system diseases such as hypogonadism, rheumatic immune diseases, gastrointestinal diseases, blood system diseases, neuromuscular diseases, chronic kidney disease and cardiopulmonary diseases. Take drugs that affect bone metabolism, including glucocorticoids, antiepileptic drugs, aromatase inhibitors, gonadotropin releasing hormone analogues, antiviral drugs, thiazolidinediones, proton pump inhibitors, and excessive thyroid hormones [4].

(7)   The IOF one-minute Osteoporosis test (Table 1) is used, and as long as the answer to one of the questions is "yes", the population is at high risk of osteoporosis.

(8)   OSTAIndex ≤-4, (Note that this table is only for postmenopausal women.)

 

The table for the last two is here, so check it out for yourself

(4)So how can osteoporosis be diagnosed?

Diagnosis can be confirmed by dual-energy X-ray absorptiometry (DXA), quantitative CT examination, radiography, bone mineral density ultrasound, and bone turnover markers. If the problem is found, the doctor should seek medical attention in time, and the doctor will choose a reasonable laboratory test for the patient who suspects osteoporosis according to the actual situation.

(5)So a lot of people ask, what happens when you have osteoporosis?

(1)   Fragility fractures: Once osteoporosis occurs, your bones are like fragile vases, and even a normal fall will cause your bones to open up and force you to stay in bed. Surgery, older, more risky, fragility fracture after surgery will still occur again. Without surgery, long-term bed rest will also bring fatal injuries to the elderly, a variety of troubles will ensue, not to mention bone will be more loose, immunity like a deflated ball, bedsores and pneumonia will also come out of trouble. Data show that about 20% of elderly patients with hip fracture die from various complications within 1 year, and about 50% become disabled.

(2)There will be chronic back pain for unknown reasons: if you think of chronic back pain as a naughty "child", when you want to turn over, "it" will grab your waist, so that you can't move, when you want to sit up, "it" will pull your coat corner, so that you have to get up carefully, when you walk for a long time, "he" will send you "whole body bone pain" and "whole body pain" gift package. You want to catch him, but you can't, and you want to find out where "it" came from? I can't find it. At this time, you may wish to consider whether this "naughty child" is a gift of "osteoporosis".

(3) Shorter or spinal deformity: many elderly people, the longer the rickets, this may be caused by osteoporosis, because serious osteoporosis patients can shorten the height and spine deformity such as hunchback, there will be lower limb joint pain it.

(4)Psychological abnormalities and low quality of life: patients with osteoporosis may have psychological abnormalities such as fear, anxiety, depression and decreased self-care ability.

(6) How can we prevent osteoporosis?

Treatment is the doctor's thing, if you are the above high-risk group, and have osteoporosis related symptoms, it is recommended to see a doctor as soon as possible, give everything to the doctor, as long as you listen to do it.

The most important thing we can do is to prevent osteoporosis, so let's do it.

(1)   Scientific Diet: First of all, each of us should try to be a "foodie" and taste a variety of delicious foods, such as vegetables, fish, eggs, tofu, mushrooms, oats and so on. In addition, the calcium content of food in the Chinese population is usually low, and they want to have hard bones, and there are additional calcium supplements, such as drinking milk every day, or oral calcium tablets, to ensure that the total daily intake of calcium reaches 800~1200mg/d.

(2)   Pay attention to smoking cessation, limit alcohol consumption,Avoid excessive consumption of coffee and carbonated beverages, eat a low-salt diet, drink plenty of water, and keep your stools open.

(3)   To ensure more sun synthesis of vitamin D: the correct method of sun exposure is to expose the skin of the face and arms for 15 to 30 minutes to meet the needs of synthesis, it is recommended to choose the time period of relatively soft sunlight (adjusted according to the season, region, latitude, etc.), avoid strong sunlight exposure, to prevent burning the skin, note that indoor exposure is ineffective exposure.

(4)   Reasonable movement:Daily exercise should be based on weight-bearing, resistance exercise and balance training, which can not only strengthen muscle mass and improve body balance, but also improve bone density, maintain bone structure, and reduce the risk of falls and fractures.

middle-agedBased on aerobic exercise, combined with whole-body muscle strength training, 3 to 7 times a week, the amount of exercise gradually increases ;

Old peopleYou can choose from moderate exercise such as walking, jogging, dancing and cycling, as well as strength training such as dumbbell, Taijiquan, Wuqin Opera and Baduanjin. In addition, the elderly should also increase the hands and knees, sitting, standing and other balance exercises, 3 to 5 times a week, it is not recommended to squat, climbing stairs, climbing and other sports, to avoid bending, bending and other excessive exercise or inappropriate exercise caused by the side damage.

 

Osteoporosis, known as the "silent killer of the elderly";, we should pay attention to it, prevent it early, and avoid the occurrence of tragedy.

 

Author:

Wang Jin

Health Management Medical Center, the Second Affiliated Hospital of Dalian Medical University

Reviewer:

Cold loosening

Vice President, Health Management Branch, Chinese Geriatric Society

Health Management Medical Center, the Second Affiliated Hospital of Dalian Medical University