Osteoporosis Diagnosa and Treatment
Osteoporosis is characterized by low bone mass and deterioration of bone tissue leading to bone fragility and an increased fracture risk. The World Health Organization classifies bone mass on the basis of T scores. A T score is the number of standard deviations from the mean bone mineral density (BMD) for the young normal population. Normal bone mass is a T score greater than -1, osteopenia is a T score of -1 to -2.5, and osteoporosis is a T score less than -2.5.
Three categories of osteoporosis have been described: (1) postmenopausal osteoporosis affects primarily trabecular bone in the decade after menopause, (2) age-related osteoporosis results from bone loss that begins shortly after peak bone mass is obtained and affects both cortical and trabecular bone, and (3) secondary osteoporosis is caused by certain medications and diseases and affects both types of bone.
Age-related bone loss results from increased bone resorption. Increased osteocyte apoptosis may decrease responses to mechanical strain and hinder bone repair. Aging also increases fracture risk because of comorbid conditions, cognitive impairment, medications, deconditioning, inadequate calcium intake, and inadequate intake and absorption of vitamin D.
The lower osteoporosis incidence in men may result from higher peak BMD, slower rate of bone loss after the peak, shorter life expectancy, fewer falls, and a more gradual cessation of hormone production.
Prevention and Treatment of Osteoprosis :
- All individuals should have a balanced diet with adequate intake of calcium and vitamin D. If adequate dietary intake cannot be achieved, calcium supplements are necessary.
- Smoking cessation increases BMD, whereas continued smoking decreases BMD and increases fracture risk.
- Although 2 to 5 cups of coffee produce small increases in calcium excretion, this effect can be offset by increased calcium intake.