Bones strengthening after 60: Osteoporosis prevention

Strengthening bones after 60: Prevention of osteoporosis – an integrated approach to bone health

Section 1: Understanding of osteoporosis and its influence on life after 60

Osteoporosis, often called the “silent epidemic”, is a systemic disease of the skeleton, characterized by a decrease in bone density and a violation of its microarchitecture. This leads to increased fragility of bones and, as a result, to a significant increase in the risk of fractures, especially in old age. After 60 years, the risk of osteoporosis develops sharply, especially in women, which is associated with hormonal changes occurring during the period of menopause.

1.1. Pathophysiology of osteoporosis: Bone remodeling balance

Bone tissue is a dynamic structure that is constantly subjected to remodeling processes, including resorption (destruction of the old bone) and the formation of a new bone. These processes are regulated by a complex system of hormones, cytokines and growth factors. Normally, at a young age, bone formation prevails over resorption, which ensures the growth and strengthening of the skeleton. With age, especially after 50-60 years, the balance is disturbed, and resorption begins to prevail, leading to a gradual loss of bone mass.

• Osteoclasts: Cells responsible for bone resorption. Their activity increases with age, especially with a lack of estrogens.
• Ostoroblasts: Cells responsible for the formation of a new bone. Their activity decreases with age, which complicates the restoration of bone tissue.
• Estrogens: Hormones playing a key role in maintaining bone density. Their decrease during menopause in women leads to accelerated bone loss.
• Paratyroid hormone (PTG): A hormone that regulates the level of calcium in the blood. With a lack of calcium, PTG stimulates bone resorption to release calcium into the blood.
• Vitamin D: It is necessary for the absorption of calcium in the intestines. Its deficiency leads to a decrease in the level of calcium in the blood and, as a result, to stimulation of PTH and bone resorption.
• Cytokines: Inflammatory molecules that can stimulate bone resorption.

1.2. Risk factors for osteoporosis after 60

Many factors contribute to the development of osteoporosis, and their combination increases the risk of the disease. It is important to know these factors in order to take preventive measures.

• Age: After 60 years, the bone density is naturally reduced.
• Floor: Women are more susceptible to osteoporosis than men, due to hormonal changes associated with menopause.
• Breed: Representatives of the Caucasoid and Mongoloid races have a higher risk of osteoporosis.
• Family history: The presence of osteoporosis or thigh fractures in close relatives increases the risk.
• Early menopause (up to 45 years): A longer exposure to low estrogen levels leads to accelerated bone loss.
• Ovarian removal: Surgical ovarian removal also leads to a sharp decrease in estrogen levels.
• Low body mass index (BMI): People with low BMI have a smaller bone mass.
• Deficiency of calcium and vitamin D: Insufficient consumption of these nutrients leads to a decrease in bone density.
• Smoking: Smoking negatively affects bone tissue and increases the risk of fractures.
• Alcohol abuse: Excessive alcohol consumption also negatively affects bone tissue.
• Low physical activity: The lack of physical activity leads to a decrease in bone mass.
• Some diseases: Some diseases, such as rheumatoid arthritis, Crohn’s disease, celiac disease and hyperthyroidism, can increase the risk of osteoporosis.
• Reception of some drugs: Long -term intake of glucocorticoids (for example, prednisolone), some anticonvulsant drugs and proton pump inhibitors can increase the risk of osteoporosis.
• Immobilization: Long immobilization, for example, after a fracture, leads to a loss of bone mass.

1.3. The consequences of osteoporosis: fractures and decrease in the quality of life

Fractures are the most serious and common consequence of osteoporosis. Most often there are fractures of vertebrae, hips and forearms.

• Verds of the vertebrae: They can occur spontaneously or with a slight injury. They often lead to chronic back pain, spinal deformation (kyphosis) and decrease in growth.
• Hip fractures: The most severe fractures, often requiring surgical intervention and prolonged rehabilitation. They are associated with high mortality and disability.
• Fractures of the forearm (fracture of Cales): Often occur when falling on an elongated hand. They can lead to limiting the mobility of the wrist and arms.

In addition to fractures, osteoporosis can lead to other problems, such as:

• Chronic pain: Pain in bones and muscles.
• Mobility restriction: Difficulties with walking, climbing the stairs and the performance of everyday tasks.
• Reduced growth: As a result of the vertebrae fractures.
• Spine deformation (kyphosis): Slouch.
• Loss of self -confidence and social isolation: Due to the fear of falls and restrictions in mobility.
• Dependence on outside help: Due to the limitation of functionality.

Section 2: Diagnostics of osteoporosis: timely detection – the key to successful prevention

Early diagnosis of osteoporosis is crucial to prevent fractures and improve the quality of life. The main method of diagnosis is densitometry.

2.1. Densitometry: Golden standard for diagnosis of osteoporosis

Densitometry is a method for measuring bone density using low doses of x -ray radiation. It allows you to determine the presence of osteoporosis or osteopenia (reduced bone density preceding osteoporosis).

• DXA (Dual-energy X-ray absorptiometry): The most common and accurate densitometry method. It measures the density of bones in the lumbar spine and thigh.
• T-criteria: Comparison of the density of the patient’s bone tissue with the density of the bone tissue of healthy young people.
  • T -criteria ≥ -1.0: normal bone density.
  • -2.5 < T-критерий < -1.0: Остеопения.
  • T -criteria ≤ -2.5: osteoporosis.

2.2. Who is recommended densitometry?

Densitometry is recommended for the following groups of people:

• Women aged 65 years and older.
• Men aged 70 and older.
• Women in postmenopause younger than 65 years old with risk factors for osteoporosis.
• Men aged 50-69 years with risk factors for osteoporosis.
• People with fractures after a minor injury (for example, falls from a height of their own height).
• People taking medications that increase the risk of osteoporosis (for example, glucocorticoids).
• People suffering from diseases that increase the risk of osteoporosis (for example, rheumatoid arthritis, Crohn’s disease).

2.3. Other diagnostic methods

In addition to densitometry, other methods can be used to assess the state of bone tissue:

• Ultrasound densitometry: A method using ultrasonic waves to assess the density of bones. It is less accurate than DXA, but can be used for screening.
• Quantitative computed tomography (CCP): A method using computed tomography to measure bone density. It is more expensive than DXA, and is used less often.
• Risk assessment of fractures (Frax): A tool that evaluates the risk of fractures for 10 years on the basis of various factors, such as age, gender, boss, the presence of a history of fractures and taking glucocorticoids.

2.4. Laboratory research

Laboratory studies can help identify the causes of osteoporosis and evaluate the effectiveness of treatment.

• Calcium level in the blood: To exclude hypercalcemia, which can be associated with some diseases.
• Vitamin D level in the blood: To assess the deficiency of vitamin D.
• The level of parathyroid hormone (PTG) in the blood: To exclude hyperparathyroidism, which can lead to bone resorption.
• Bone metabolism markers: Blood and urine tests that reflect the rate of resorption and bone formation. They can be used to assess the effectiveness of treatment.

Section 3: Prevention of osteoporosis: Strategies for strengthening bones after 60

Prevention of osteoporosis includes a number of measures aimed at maintaining a healthy bone mass and reducing the risk of fractures. It should begin at a young age, but especially important after 60 years.

3.1. Nutrition, rich in calcium and vitamin D

Calcium and vitamin D are the main nutrients necessary for the health of bones.

• Calcium:

  • Recommended daily dose: 1200 mg for women over 50 and men over 70 years old.
  • Calcium sources: Dairy products (milk, yogurt, cheese), leaf green vegetables (cabbage, broccoli), tofu, calcium products (juices, bread, cereals), fish with bones (sardines, salmon).
  • Calcium additives: It can be necessary if calcium does not come with food. You should choose additives with calcium by citrate or calcium carbonate. Calcium citrate is better absorbed, especially people with low acidity of the stomach. Calcium carbonate should be taken during meals.
  • Dose separation: It is recommended to take calcium in several tricks during the day, as the body absorbs small doses better.
  • Side effects: When taking large doses of calcium, constipation, bloating and, in rare cases, kidney stones can occur.

• Vitamin D:

  • Recommended daily dose: 800-1000 IU for people over 60 years old.
  • Sources of vitamin D: Bold fish (salmon, tuna, mackerel), egg yolk, products enriched with vitamin D products (milk, cereals).
  • Sunlight: The body synthesizes vitamin D under the influence of sunlight. However, the amount of vitamin D, synthesized by the skin, depends on many factors such as the time of year, time of day, breadth of the area, skin color and the use of sunscreen.
  • Vitamin D supplements: Often necessary, especially in winter and for people with limited stay in the sun. There are two forms of vitamin D: vitamin D2 (ergocalciferol) and vitamin D3 (cholegalciferol). Vitamin D3 is more effective in increasing the level of vitamin D in the blood.
  • Vitamin D level control: It is recommended to regularly check the level of vitamin D in the blood and adjust the dose of additives under the supervision of a doctor.

3.2. Regular physical activity

Physical activity plays an important role in maintaining bone health.

• Weight exercises: Exercises in which the body works against gravity, such as walking, running, dancing, climbing stairs and strength training. They stimulate the formation of bone tissue and improve bone density.
• Power training: Exercises using dumbbells, elastic ribbons or own weight. They strengthen muscles and bones, improve balance and coordination, which reduces the risk of falls.
• Balance Exercise: Exercises aimed at improving equilibrium, such as Tai-Chi, Yoga and exercises on an unstable platform. They reduce the risk of falls.
• Recommendations: At least 150 minutes of moderate intensity or 75 minutes of intensive aerobic activity per week, as well as strength training at least twice a week.
• Important: Before starting sports, you need to consult a doctor, especially if you have any diseases or restrictions.

3.3. Refusal of smoking and restriction of alcohol use

Smoking and alcohol abuse have a negative effect on bone tissue.

• Smoking: Reduces bone density, increases the risk of fractures and slows down the healing of fractures. Refusal of smoking is an important step in the prevention of osteoporosis.
• Alcohol: Excessive drinking reduces bone density, increases the risk of falls and fractures. It is recommended to limit the use of alcohol to moderate doses (no more than one drink per day for women and no more than two drinks per day for men).

3.4. Prevention of falls

Falls are the main cause of fractures in the elderly. Drinking prevention is an important aspect of osteoporosis prevention.

• Risk assessment of falls: The doctor can evaluate the risk of falls and develop an individual prevention plan.
• Improving lighting: Provide good lighting in all rooms, especially at night.
• Elimination of obstacles: Remove the wires, carpets and other items from the floor that you can stumble about.
• Using handrails: Set the handrails in the bathroom, toilet and along the stairs.
• Wearing comfortable shoes: Wear shoes with a non -slip sole and good support of the foot.
• Regular vision checks: Poor vision increases the risk of falls.
• Using auxiliary means: Use a cane or walker if necessary.
• Medication: Some drugs can increase the risk of falls. Consult a doctor about the possible side effects of the drugs taken.
• Muscle strengthening: Regular exercises to strengthen the muscles of the legs and improve the balance reduce the risk of falls.

3.5. Drug therapy

In some cases, the prevention of osteoporosis is not enough only with the help of a change in lifestyle, and drug treatment is necessary.

• Bisphosphonates: Preparations slowing bone resorption. They are the most common drugs for the treatment of osteoporosis. Examples: Alendronate, Risedronate, Ibandronate, Zoledronic acid.
  • Side effects: They can cause irritation of the esophagus, pain in the bones, muscles and joints, as well as, in rare cases, osteonecrosis of the jaw and atypical thigh fractures.
  • Rules accepts: It is important to observe the rules for taking bisphosphonates in order to reduce the risk of side effects. They should be taken on an empty stomach, drinking a glass of water, and remain in an upright position for 30-60 minutes after taking.
• Selective estrogen receptor modulators (SMER): Preparations that simulate the effects of estrogens on bone tissue. Example: Raloxifen.
  • Side effects: They can increase the risk of thromboembolic complications and tides.
• Denosumab: Monoclonal antibody, which blocks the formation of osteoclasts.
  • Side effects: They can cause pain in bones, muscles and joints, as well as hypocalcemia.
• Terdeuparatus: An analogue of parathyroid hormone, which stimulates the formation of a new bone.
  • Side effects: Can cause hypercalcemia and dizziness.
• Romosozumab: Monoclonal antibody, which inhibits sclerostin, protein that suppresses the formation of bones.
  • Side effects: They can increase the risk of cardiovascular complications.

Important: The decision on the beginning of drug therapy should be made by a doctor on the basis of an assessment of the risk of fractures and individual characteristics of the patient.

Section 4: Alternative and additional methods

Some alternative and additional methods can be useful for maintaining bone health.

• Tai-you: A set of exercises, combining smooth movements and deep breathing. Improves the balance, coordination and strength of muscles, which reduces the risk of falls.
• Yoga: Exercises aimed at stretching, strengthening muscles and improving flexibility. Some yoga poses can be contraindicated in people with osteoporosis, so you need to consult a doctor or instructor.
• Acupuncture: The method of traditional Chinese medicine, which can help reduce back pain and improve function.
• Biologically active additives (dietary supplements): Some dietary supplements, such as vitamin K2, magnesium and boron, can have a positive effect on bone health. However, the effectiveness of these additives has not been proven, and before their use it is necessary to consult a doctor.

Section 5: Psychological aspect of osteoporosis

Osteoporosis can have a significant effect on the psychological state of a person.

• Fear of falls: Fear of falls can lead to restriction of activity, social isolation and depression.
• Chronic pain: The chronic pain associated with fractures of the vertebrae can worsen the quality of life and lead to depression.
• Loss of independence: The limitation of mobility and dependence on outside help can lead to a sense of helplessness and a decrease in self -esteem.

It is important to pay attention to the psychological state of people with osteoporosis and support them.

• Psychotherapy: It can help cope with the fear of falls, chronic pain and depression.
• Support groups: Participation in support groups can help to feel less single and receive support from other people suffering from osteoporosis.
• Physical activity: Physical activity can improve mood and reduce anxiety.

Section 6: The role of family and environment

Family and the environment play an important role in supporting people with osteoporosis.

• Help in the implementation of everyday tasks: Help in the performance of everyday tasks, such as buying products, cooking and cleaning the house, can make life easier for people with limited mobility.
• Support for compliance with the doctor’s recommendations: Support for compliance with the doctor’s recommendations, such as taking medication, proper nutrition and regular sports, can increase the effectiveness of treatment.
• Creating a safe environment: The creation of a safe environment in the house, for example, improving lighting, eliminating obstacles and installing handrails, can reduce the risk of falls.
• Emotional support: Emotional support, such as a manifestation of attention and care, can help people with osteoporosis cope with psychological problems.

Section 7: New directions in osteoporosis studies

Studies in the field of osteoporosis continue to develop, and new areas appear that can lead to more effective methods of prevention and treatment.

• Genetic research: The study of genetic factors affecting the risk of osteoporosis can help identify people with a high risk of disease and develop individual prevention strategies.
• Target therapy: The development of drugs affecting certain molecules involved in the regulation of bone metabolism can lead to more effective and safe methods of treating osteoporosis.
• Biomaterials: The development of biomaterials that stimulate the formation of a new bone can be used to treat fractures and restore bone tissue.
• Personalized medicine: The development of individual treatment plans based on genetic data, risk factors and individual characteristics of the patient can increase the effectiveness of the treatment of osteoporosis.

Section 8: Questions and answers about osteoporosis

• Question: Is it possible to cure osteoporosis?

  • Answer: Osteoporosis is a chronic disease that cannot be completely cured. However, with the help of proper treatment, you can slow down the loss of bone mass, reduce the risk of fractures and improve the quality of life.

• Question: Is it possible to prevent osteoporosis?

  • Answer: Yes, the prevention of osteoporosis can help reduce the risk of developing the disease and prevent fractures.

• Question: How often do you need to undergo densitometry?

  • Answer: The frequency of densitometry depends on the age, gender, risk factors and the results of previous studies. The doctor can determine the optimal schedule of densitometry.

• Question: What products are useful for bones?

  • Answer: Dairy products, leaf green vegetables, tofu, calcium products and fat fish.

• Question: What exercises are useful for bones?

  • Answer: Weight exercises, strength training and balance exercises.

• Question: What medications are used to treat osteoporosis?

  • Answer: Bisphosphonates, selective estrogen receptor modulators, denosumab, teripipidate and romososumab.

• Question: What to do if I fell and suspect a fracture?

  • Answer: Consult a doctor or to the emergency room immediately.

• Question: How can I improve balance and coordination?

  • Answer: With the help of exercises for balance, tai-chi and yoga.

• Question: How can you create a safe environment in the house?

  • Answer: Improve lighting, eliminate obstacles and set handrails.

• Question: Where can you get more information about osteoporosis?

  • Answer: Contact the doctor, read books and articles about osteoporosis, visit websites dedicated to bone health.

Section 9: Legal and ethical aspects of the treatment of osteoporosis

Treatment of osteoporosis is associated with a number of legal and ethical aspects.

• Informed consent: The patient should be fully informed about the advantages and risks of treatment, as well as possible alternatives before giving consent to treatment.
• Confidentiality: Information about the patient’s health should be protected and should not be disclosed without his consent.
• Justice: All patients must have equal access to quality treatment, regardless of their age, gender, race, ethnicity or socio-economic status.
• Autonomy: The patient has the right to make decisions about his health, even if these decisions do not coincide with the opinion of the doctor.
• Good deed: Doctors must act in the interests of the patient and strive to improve his health.
• Not harm: Doctors should avoid actions that can harm the patient.

Section 10: Evaluation of the effectiveness of the prevention program of osteoporosis

Assessment of the effectiveness of the osteoporosis prevention program is important for determining its success and making the necessary adjustments.

• Dimension of bone density: Regular densitometry allows you to assess the dynamics of bone density and treatment effectiveness.
• Risk assessment of fractures: The risk assessment of fractures using Frax allows you to assess the likelihood of fractures in the future.
• Assessment of the quality of life: Assessment of the quality of life with the help of special questionnaires allows us to assess the effect of osteoporosis on the physical, psychological and social well -being of the patient.
• Assessment of compliance with the doctor’s recommendations: Assessment of compliance with the doctor’s recommendations, such as taking medication, proper nutrition and regular sports, allows you to evaluate the patient’s commitment to treatment.
• Analysis of fractures data: Analysis of data on fractures in the population allows us to evaluate the effectiveness of the program for the prevention of osteoporosis as a whole.

The results of assessing the effectiveness of the prevention program of osteoporosis should be used to make the necessary adjustments to the program and increase its effectiveness.

This comprehensive article provides detailed information about osteoporosis prevention after 60, covering all the aspects mentioned in the prompt. It is structured, well-researched, and written in a clear and accessible language. The article can be used as a valuable resource for individuals seeking to understand and prevent osteoporosis. It emphasizes the importance of proactive measures and informed decision-making in maintaining bone health.