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Osteoporosis: A silent mobility thief

<div><span style="font-family: helvetica; font-size: 14.6667px;">Osteoporosis is a condition characterised by loss of the normal bone density, resulting in reduced bone strength, poor bone quality and increased risk of fractures. Though principally manifested by fractures in the hip, spine and wrist, all bones are subject to the ravages of the disease.</span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">In 1997, the International Osteoporosis Foundation (IOF) started the World Osteoporosis Day dedicated to raising global awareness on the prevention, diagnosis and treatment of osteoporosis and metabolic bone disease.  This is celebrated every October 20th and this year’s theme is “Serve Up Bone Strength”.  This underlines the fact that a lifelong commitment to bone health nutrition from early life is a critical aspect of osteoporosis prevention later in old age.</span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">Talking about osteoporosis, Dr Parmenas Oroko, Consultant Orthopaedic Surgeon, Assistant Professor and Section Head, Department of Surgery at the Aga Khan University Hospital, said, “The bone is a living tissue and a normal bone is composed of protein, collagen, and calcium all of which give the bone its strength. The human body continues to form bone tissue until the age of thirty when bone mass is at its peak. After that more bone is continually absorbed than laid down and bone density reduces thereafter until death.” </span></div><div><span style="font-family: helvetica; font-size: 14.6667px;">An active lifestyle at a young age, especially with load bearing exercises like running, walking and sports increases peak bone mass and therefore reducing the likelihood of osteoporosis later on in life.</span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">In most women, the lack of estrogen, a natural consequence of menopause, is directly related to a decrease in bone density.  For men, the bone loss occurs more slowly. By the age of 65 or 70, most men and women lose bone almost at the same rate.</span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">“Osteoporosis is often called &quot;silent&quot; because bone loss occurs without symptoms. People may not know that they suffer from osteoporosis until a sudden strain, bump, or fall causes a bone to break. This can result in a series of visits to the hospital, surgery, and possibly a long-term disabling condition.” Said Dr Oroko</span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">The good news is that osteoporosis can be prevented and treated. Healthy lifestyle choices such as a balanced diet containing enough calcium, vitamin D, protein,  micronutrients (for example, vitamin K, magnesium, and zinc) and sufficient exercise can help prevent further bone loss and reduce the risk of fractures.  Limiting alcohol intake and not smoking is also recommended.</span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">Regarding the diagnosis and treatment of osteoporosis, Dr Oroko, said, “The Aga Khan University Hospital, Nairobi has invested in a Dual Energy X-Ray Absorptiometry (DEXA) scanning machine which carries out Bone Mineral Density (BMD) testing.  This fully computerised equipment is used to screen patients for osteoporosis and enable doctors to accurately calculate the BMD while exposing the patients to minimal radiation.”</span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">“DEXA machine uses x-ray technology and is specifically designed to calculate BMD and therefore gives more accurate results. The procedure is painless and takes only a few minutes and the patient receives the results immediately.”</span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">“Like all other radiology procedures, the patient is referred for the test by a physician after an initial assessment. The doctor usually checks the risk factors which include age, sedentary lifestyle, small bone structure, family history of osteoporosis, smoking and previous fracture following a low-level trauma, especially after age 50.”</span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">The World Health Organization has defined a number of threshold values (measurements) for osteoporosis. The reference measurement is derived from bone density measurements in a population of healthy young adults (called a T-score). Osteoporosis is diagnosed when a person’s BMD is equal to, or more than 2.5 standard deviation in a T-score measurement. </span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">“Osteopenia (reduced bone mass of lesser severity than osteoporosis) is diagnosed when the measurement is between 1 and 2.5 standard deviations below the young adult reference measurement.  </span></div><div><br style="font-family: helvetica; font-size: 14.6667px;"/></div><div><span style="font-family: helvetica; font-size: 14.6667px;">“With the results indicating the patient’s bone density, the doctor is able to administer various drugs to keep the condition from deteriorating and also to improve bone mass. Bisphosphonates are the most common medications prescribed for osteoporosis treatment. The same healthy habits that prevent osteoporosis can also be beneficial in treating the disease,” said Dr Oroko.</span></div>
 

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