Five things to know about osteoporosis

Written by Helen Foster for Australian Seniors

Around 6.2 million Australians have osteoporosis, or its precursor osteopenia, and this number has risen by 31% in the last 10 years. Professor Peter Wong, honorary medical director at Healthy Bones Australia, explains five key things to know about the condition.

What is osteoporosis?

Osteoporosis (meaning ‘bones with holes’) is a thinning of the bones that makes them more vulnerable to damage. It occurs when minerals such as calcium are lost at a quicker rate than the body can replace them, causing the bones to become brittle.

When the bones are thin and porous, even small knocks can cause a fracture or break. Osteoporosis is painless; most people have no idea they have it, until they fall and break something. Anyone over the age of 50 who fractures a bone after a fall from standing height, or lower, should be checked for osteoporosis. 

What causes osteoporosis? 

According to Healthy Bones Australia, there are a number of risk factors that see men and women develop osteoporosis. These include a family history, low calcium intake and vitamin D levels, and a person’s medical history. A number of conditions such as coeliac disease, thyroid conditions and kidney disease, along with low hormone levels associated with menopause, may increase risk. Certain medications to treat breast and prostate cancer, epilepsy, depression, HIV, and corticosteroid use have also been linked to osteoporosis. 

Lifestyle factors such as smoking, excess alcohol intake, and lack of physical activity, along with body weight and build also put people at greater risk of developing osteoporosis.  

How to treat osteoporosis? 

We have medication now that can help preserve bone mass. The most commonly used, bisphosphonates, can be given in tablet form or via an infusion delivered once a year. Some newer medications also promote bone growth. The newest, romosozumab, is the best we’ve seen at this but it’s expensive, so it’s only offered under certain indications. Healthy Bones Australia is campaigning to broaden access but if you have very severe osteoporosis or have had a fracture while on standard medication, you should consider discussing it with your health care team. 

How can we prevent osteoporosis? 

We build the majority of our bones in our 20s, but you do still grow some in later years so a healthy lifestyle will help preserve the ones you have. Ensure you have an adequate dietary intake of calcium and vitamin D, it’s also recommended that you do regular weight-bearing and strength-training exercise and don’t smoke. You can even ask your GP whether you qualify for a DEXA scan under Medicare to measure bone thickness to spot any concerns.

How to manage it?

Follow the rules for prevention to help preserve the bones you have, but don’t be afraid to continue challenging your body. Speak to your health care team about adapting exercises to reduce fracture risk. The most important aspect of managing osteoporosis is reducing the likelihood of a fall as recovery from a fracture later in life is not always easy. Fixing things like wobbly steps around the house or considering a stick for support are some of the most important things you can do. 

Who is most at risk?

Age is the most common risk factor – as we get older the cells that eat up bone become more active than the ones that build it. Over the age of 50, one in three women and one in five men will develop an osteoporotic fracture. Medications, particularly steroids like prednisone, which is used to control many conditions, and some common treatments for prostate or breast cancer, can accelerate thinning of the bones. Family history may also play a role.  

While osteoporosis becomes more likely as we get older, knowing your risk and monitoring your bone health with your doctor are critical first steps that could prevent fractures and keep you mobile.