Osteoporosis occurs when bone density and quality decrease, leading to brittle bones. It often progresses silently until a fracture occurs, typically in the hip, spine, or wrist. While it can affect anyone, osteoporosis is particularly common in postmenopausal women and older adults.

Who Should Be Screened for Osteoporosis?

Screening for osteoporosis is crucial because it helps identify individuals at risk before fractures occur. The following groups should consider screening:

• Women aged 65 and older
• Men aged 70 and older, regardless of risk factors. Although Australian Medicare rules are slightly different.

Postmenopausal women under 65 and men aged 50-69 with risk factors such as:

• Family history of osteoporosis or fractures.
• Low body weight or a history of eating disorders.
• Use of medications that weaken bones, like long-term corticosteroids.
• Lifestyle factors such as smoking, excessive alcohol use, and physical inactivity.
• Adults with a history of fractures after age 50.
• People with certain medical conditions that affect bone health, like rheumatoid arthritis, hyperthyroidism, or malabsorption disorders.

The most common screening test is the DEXA scan (Dual-Energy X-ray Absorptiometry), which measures bone mineral density and helps assess fracture risk.

Treatments for Osteoporosis

Once diagnosed, osteoporosis can be managed with a combination of lifestyle changes, medications, and sometimes, medical procedures.

Lifestyle Modifications:

• Diet: Ensure sufficient intake of calcium and vitamin D. Calcium-rich foods include dairy products, leafy greens, and fortified foods. Vitamin D can be obtained from sunlight, food, and supplements.
• Exercise: Weight-bearing and muscle-strengthening exercises help improve bone strength and balance, reducing the risk of falls.
• Fall Prevention: Modify the home environment to reduce fall risks, such as removing tripping hazards and improving lighting.

Medications:

Several medications can help maintain or improve bone density, including:

• Bisphosphonates: (e.g., alendronate, risedronate) which slow bone loss.
• Denosumab: a monoclonal antibody that reduces bone breakdown.
• Selective Estrogen Receptor Modulators (SERMs): like raloxifene, which help maintain bone density in postmenopausal women.
• Hormone Therapy: which may be an option for some postmenopausal women.
• Anabolic agents: such as teriparatide or romosozumab that help stimulate new bone growth.

Other Treatments:

In severe cases, vertebroplasty or kyphoplasty may be considered for spinal fractures.

Osteoporosis is a manageable condition when detected early. Regular screening for those at risk and a proactive approach to treatment can significantly reduce the risk of fractures and improve quality of life. If you or someone you know may be at risk, speak with a healthcare provider about screening and preventive measures.

Everyone over 70 every 5 years unless it is abnormal in which case every 2 years. and other at risk people at a younger age.