Introduction - Why all the fuss?

Osteoporosis has emerged as one of the most important diagnoses of the 1990's. Why the intense interest? The answer has several components. The recent introduction of new effective non-hormonal medication for the treatment of osteoporosis has catapulted the field into a new era but perhaps the most significant cause for the renewed interest is the growing awareness of the staggering implications of the disease. Osteoporosis should be of utmost importance to all because it is so common. Fortunately, it is a disease that is easily diagnosed, and more importantly, it is a disease that can be prevented and treated.

What is Osteoporosis and Osteopaenia?

Osteoporosis is a bone disease characterised by low bone mass and micro- architectural deterioration of bone, both of which lead to increased bone fragility and increased risk of fracture. In simpler terms, it can be considered as a disease process that weakens bones to the extent that they can be relatively easily broken.

Osteopaenia is defined as low bone mass without the microarchitectural deterioration and can be considered a precursor of osteoporosis. It should be emphasised that osteoporosis and osteopaenia are a continuum of the same disease process.

What are the more important consequences of Osteoporosis?

The most dreaded clinical manifestation of osteoporosis are fractures and their complications. Sites of common fractures include the spine, hip, wrist and proximal humerus (upper arm).

At age 50, 4 in 10 women can expect to sustain one or more osteoporosis-associated fractures in their lifetime.

Hip fractures are especially devastating

• Up to 20% of patients die, particularly the elderly. For women this risk is as great as that of cardiovascular (heart) disease and 6 times higher than that of breast cancer.
• Up to 50% of patients have significant disability within a year of injury.

Who is at risk of developing Osteoporosis?

Bone loss is an asymptomatic process and in some ways can be clinically likened to hypertension. In each case patients present themselves to the health care system when a complication arises, either fracture in the case of osteoporosis, or stroke in hypertension.

Risk Factors for Osteoporosis & Osteoporosis Fractures

How can I tell the health of my bones?

It is important to understand that bone is not a hard and lifeless structure; it is, in fact, complex, living tissue. Our bones supply structural support for muscles, protect vital organs, and store the calcium essential for bone density and strength.

Until the age of about 30, you build and store bone efficiently. Then, as part of the natural ageing process, your bones begin to break down faster than new bone can be formed. In women, bone loss accelerates after the menopause, when your ovaries stop producing oestrogen - the hormone that protects against bone loss.

Think of your bones as a savings account. There is only as much bone mass in your account as you deposit. The critical years for building bone mass are from prior to adolescence to about age 30. Some experts believe that young women can increase their bone mass by as much as 20% - a critical factor in protecting against osteoporosis.

Next>> Part 2 - How do I know if I have Osteoporosis?