What is Osteoporosis?
Osteoporosis is a condition where your bones weaken and are at a greater risk of fracturing.
As we age our bone density naturally decreases. We all reach peak bone density around the age of 25, this begins to plateau in our 30s and then gradually decline. However, certain things can speed up this process. As our bones weaken they are more likely to break from smaller impacts, these breaks are known as fragility fractures.
Osteopenia is considered where your bone mineral density (BMD) is lower than the average person, but not yet at the level of osteoporosis.
How do I know if I have low bone density?
1 in 3 women and 1 in 5 men, over the age of 50, will break a bone due to poor bone health.
Unfortunately there are often no symptoms until you break a bone - that is why osteoporosis is called a “silent disease”. Most people only find out they have low bone density once they have a DEXA (DXA) scan.
Knowing your risk factors is really important and if you feel you are at risk have a chat with your GP or doctor about getting assessed.
Risk Factors
There are many known risk factors for osteopenia and osteoporosis.
These include (but are not limited to):
Ageing
Gender
Genetics
Certain medical conditions (rheumatoid arthritis, anorexia nervosa, hyperthyroidism, crohn's disease, coeliac disease)
Certain medications (Glucocorticoids (steroid) tablets, certain breast and prostate cancer treatments)
Smoking
Low body weight
Increased alcohol consumption
The Stats
1 in 3 women and 1 in 5 men, over the age of 50, will break a bone due to poor bone health.
In Ireland there are over 300,000 people diagnosed with osteoporosis and an estimated > 1 million people with low bone density.
In the UK there are over 3.5 million people diagnosed with osteoporosis.
In Ireland there were 32,000 fragility fractures in 2019. This is predicted to hit 51,000 by 2034.
In the EU 71% of women at a high fracture risk are not receiving treatment.
Worldwide there are over 200 million women diagnosed with osteoporosis.
The most common fracture sites are the hip, wrist and spine.
Exercise Statistics
Exercise and balance programs have been shown to reduce falls.
Exercise is recommended for the prevention and management of osteoporosis, fragility fractures and falls.
However exercise recommendations should be specific to individuals and not generalised across entire populations.
Emerging research suggests that impact exercise combined with high intensity progressive resistance (strength) training may slow bone loss, maintain and improve bone mineral density (BMD) in individuals with osteopenia and osteoporosis.
Impact exercise has been shown to improve bone mineral density (BMD) in premenopausal women between 31-50.
References:
CAREY, J. J., ERJIANG, E., WANG, T., YANG, L., DEMPSEY, M., BRENNAN, A., YU, M., CHAN, W. P., WHELAN, B., SILKE, C., O'SULLIVAN, M., ROONEY, B., MCPARTLAND, A. & O'MALLEY, G. 2023. Prevalence of Low Bone Mass and Osteoporosis in Ireland: the Dual-Energy X-Ray Absorptiometry (DXA) Health Informatics Prediction (HIP) Project. JBMR Plus, 7, e10798.
KANIS, J. A., NORTON, N., HARVEY, N. C., JACOBSON, T., JOHANSSON, H., LORENTZON, M., MCCLOSKEY, E. V., WILLERS, C. & BORGSTRÖM, F. 2021. SCOPE 2021: a new scorecard for osteoporosis in Europe. Archives of Osteoporosis, 16, 82.
International osteoporosis foundation
References:
SHERRINGTON, C., FAIRHALL, N. J., WALLBANK, G. K., TIEDEMANN, A., MICHALEFF, Z. A., HOWARD, K., CLEMSON, L., HOPEWELL, S. & LAMB, S. E. 2019. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev, 1, Cd012424.
SHUBERT, T. E., GOTO, L. S., SMITH, M. L., JIANG, L., RUDMAN, H. & ORY, M. G. 2017. The Otago Exercise Program: Innovative Delivery Models to Maximize Sustained Outcomes for High Risk, Homebound Older Adults. Front Public Health, 5, 54.
YANG, Y., WANG, K., LIU, H., QU, J., WANG, Y., CHEN, P., ZHANG, T. & LUO, J. 2022. The impact of Otago exercise programme on the prevention of falls in older adult: A systematic review. Front Public Health, 10, 953593.