Causes and prevention of osteoporosis in older people

The World Health Organization (WHO) defines osteoporosis as a systemic skeletal disease characterized by a decrease in bone density and disruption of bone microarchitecture, with a subsequent increase in bone fragility and an increased risk of fractures. The bones become so porous and fragile that a fracture can occur even with a slight impact - a weak blow, a fall from a small height, an awkward turn. Such fractures are called low-traumatic or low-energy fractures. The bulk of patients diagnosed with osteoporosis are people over 50 years of age: according to statistics, every third woman over 50 years of age and almost half of all men and women over 65 years of age suffer from osteoporosis. Due to the constant increase in life expectancy, the number of such patients is growing, and WHO calls osteoporosis one of the most common non-communicable diseases in the world. It ranks fourth after cardiovascular diseases, malignant tumors and diabetes.

Causes and risk factors for osteoporosis in older people

Bone tissue, like other tissues of the human body, is constantly renewed throughout life. After 50 years, this process gradually slows down and destruction begins to prevail over renewal. Calcium loss is the main cause of osteoporosis in old age. In postmenopausal women, estrogen levels decrease, which leads to calcium deficiency and, as a consequence, to bone deficiency and increased bone fragility. Therefore, osteoporosis develops earlier in women, and it is considered to be predominantly a “female” disease. In men, the hormonal factor becomes active after 60 years of age due to a decrease in testosterone levels in the blood.

Doctors divide risk factors for the development of osteoporosis into modifiable, that is, those that can be influenced, and non-modifiable, that is, those that cannot be changed.

Modifiable factors:

• Smoking.
• Long-term use of certain medications.
• Alcohol abuse.
• Deficiency of calcium intake.
• Vitamin D deficiency.
• Low physical activity.
• Prolonged immobility.

Non-modifiable factors:

• Age over 65 years.
• Female.
• Caucasian race.
• Heredity.
• Tendency to falls and previous fractures.
• Early menopause (before 45 years).
• Low body mass index.
• Low bone mineral density.
• Endocrine disorders - reduced production of sex hormones in men and women.

Remember calcium

What is osteoporosis

Thinning of bone tissue, its increased fragility and tendency to fractures. Find out more about what causes these problems.

Add foods that contain easily digestible calcium to your diet.
Its best sources are milk and dairy products, cottage cheese, cheeses, green vegetables, legumes, nuts, and fish. The minimum daily requirement of calcium
- 500 mg - can be obtained from half a liter of milk, but it is worth remembering that it is better to choose low-fat dairy products, because excess weight is also a risk factor for the development of osteoporosis.
Calcium is washed out of bones and with a lack of magnesium
, which is involved in the growth and restoration of bone tissue.
For its normal absorption, vitamin B6, contained in meat and liver, is required. And there is a lot of magnesium in legumes, whole grain products and potatoes. For good absorption of calcium, fat-soluble vitamins A and D are necessary. The first is found in animal products and vegetable oils. And the second is partially synthesized in the human body under the influence of sunlight
with sufficient consumption of fatty fish, eggs or mushrooms.

Use vitamin complexes and calcium supplements only as prescribed by a doctor and under his strict supervision.

Symptoms of osteoporosis in older people

Osteoporosis in the early stages develops asymptomatically, so the diagnosis is usually made only after a fracture. Sometimes fractures occur unnoticed by a person - these can be, for example, compression fractures of vertebrae affected by osteoporosis, which occur under the pressure of the gravity of one’s own body. All older people are at risk of developing osteoporosis, therefore, upon reaching a certain age, especially if there are other risk factors, it is necessary to undergo testing. Doctors recommend screening for fracture risk in all postmenopausal women and men over 50 years of age. Screening is carried out using the WHO-approved FRAX (Fracture Risk Assessment Tool) algorithm, which determines the 10-year probability of a low-traumatic fracture. Low-traumatic fractures in this study include fractures of the vertebrae, femur, humerus, and radius.

At the same time, there are a number of indirect symptoms that may indicate the development of osteoporosis in old age:

• The appearance of stoop.
• Decrease in height by more than 4 cm compared to 25 years of age.
• Back pain at the end of the day, after being in one position or after walking.

OSTEOPOROSIS: prevention and treatment

Who is most at risk for osteoporosis? What examination should the general practitioner carry out? Is it possible to reduce the risk of fractures?

For centuries, a widow's hump was considered evidence that a woman's life was coming to an end. Today, we not only know about the morbidity and mortality associated with osteoporosis, but also have a range of measures to prevent and treat this condition.

Bone mass increases during childhood, reaching its highest value by the age of 25; the maximum weight is determined by hereditary factors. Then, until the age of 35-40, bone mass remains stable, after which it begins to decline. In women, the rate of its decrease increases with the onset of menopause.

The loss of bone mineral is accompanied by age-related deterioration of the protein and other matrix components of bone. This loss of bone mass and destruction of bone microarchitecture leads to increased bone fragility and increases the risk of fractures [1].

The increase in the incidence of osteoporosis with age is shown in Fig. 3. Every third woman and every twelfth man will experience a fracture due to osteoporosis during their lifetime.

• What are the causes of osteoporosis?

With age, in both men and women, the absorption of calcium in the intestines decreases, which is complemented by a decrease in the level of vitamin D due to its insufficient intake from food and short-term exposure to the sun. This deficiency leads to increased secretion of parathyroid hormone and the removal of calcium from the bones.

Reduced exercise also contributes to bone loss.

Estrogen inhibits the resorption of calcium from bones, but in women with menopause, their production decreases significantly, so bone loss increases.

Many diseases lead to the development of osteoporosis, among which we note prolonged premenopausal amenorrhea, oophorectomy, early menopause, hyperparathyroidism, hyperthyroidism, malabsorption syndrome, chronic liver and kidney diseases, prolonged immobilization and steroid use. High-risk groups [2] are listed in Table. 1.

Table 1. Factors that increase the risk of fractures due to osteoporosis

Bone mass at the femoral neck and lumbar vertebrae is measured using dual energy x-ray absorptiometry (DXA). According to DXA, a decrease in bone mass by more than 2.5 standard deviations from its highest value indicates osteoporosis, and a mass value between 1 and 2.5 deviations below its highest value is defined as osteopenia [3]. Because DEXA is not available in all areas of the UK, it is often not possible to carry out this test on a housebound elderly person.

Clinical manifestations of osteoporosis at the height of the disease are reduced to pronounced kyphosis and are characterized by a decrease in height, sagging of the abdomen, associated with the fact that the lower ribs cover the crests of the iliac bones.

Most patients who have suffered a minimally traumatic fracture of the femur or vertebrae (in the absence of other causes) also suffer from osteoporosis, and in these cases it is advisable to start calcium supplementation even if DXA cannot be performed, especially if the patient is at risk (Table 1).

With the exception of DXA, there are no other extensive tests, but a few simple screening tests should be performed to rule out comorbidities.

Results of hemoglobin, ESR or blood viscosity, calcium, phosphate and alkaline phosphatase, urea and electrolytes, TSH, liver function tests and blood proteins should reveal hyperparathyroidism, osteomalacia, hyperthyroidism, chronic liver or kidney disease and myeloma.

• Prevention

Some preventative measures are suitable for everyone without exception. Ideally, prevention should begin in early childhood and include adequate calcium intake with vitamin D and regular exercise to optimize maximum bone mass.

Therefore, regular exercise and adequate amounts of calcium and vitamin D will help maintain bones. The Department of Public Health recently issued guidelines [2] recommending a daily intake of at least 700 mg of calcium for adults combined with 400 IU of vitamin D for life, and the National Osteoporosis Society suggests a minimum of 1,000 mg of calcium per day.

It is very important to ensure that the elderly patient receives the required amount of calcium, since most elderly people have inadequate nutrition. In practice, it is much easier to persuade a patient to take calcium with vitamin D than to try to change the diet.

Regular exercise should be encouraged, but in reality it is not easy to change a sedentary lifestyle that has been perpetuated by years of inactivity. The most easily accomplished form of activity is walking, and some patients take up dancing, special exercises, or water aerobics.

Sometimes the loss of a loved one can serve as an incentive to become more active in your life, which helps the healing process. It is not yet clear how intense physical activity should be to maintain skeletal system. Smoking and excessive alcohol consumption undoubtedly increase the risk of osteoporosis, of which the patient must be reassured.

An attempt should be made to identify patients at increased risk before the first fracture occurs; in many cases this is facilitated by computerized record keeping

.

Whenever possible, high-risk patients should be screened with DXA; If osteoporosis or osteopenia is detected, additional therapy is prescribed.

Hormone replacement therapy (HRT) prevents osteoporosis; According to some data, five years of taking replacement drugs reduces the incidence of fractures by 25-50%, and ten years - by 50-75%.

Unfortunately, bone loss resumes when treatment is stopped and any beneficial effects of therapy on bone are quickly lost, and few women are currently willing to take HRT without specific goals.

Recent evidence suggests that bisphosphonates given immediately after menopause also prevent bone loss and may provide an alternative method of prevention.

• Treatment of osteoporosis in older people

It is important that patients at increased risk of fractures receive treatment, namely those who have DXA-confirmed osteoporosis, or have a history of minimal traumatic hip or vertebral fractures (in the absence of other medical explanations), or who are taking at least 7.5 mg of prednisolone daily within six months. One in six women is at risk of hip and vertebral fractures in her lifetime, and therefore most older women should meet these criteria.

Once started, therapy continues for life, except in cases of steroid withdrawal and normalization of bone density.

As a preventive measure, patients should be encouraged to engage in regular exercise, including weight lifting, take calcium with vitamin D, and stop smoking and drinking alcohol to excess. Calcium and vitamin D slow the rate of bone destruction, and there is evidence that they reduce the incidence of fractures in old age [5]. A supplement containing 500 mg of calcium and 400 IU of vitamin E daily can be prescribed, but this amount is not sufficient to treat established osteoporosis.

HRT is as effective in old age as it is immediately after menopause (Fig. 4), but at older ages women are more likely to refuse it.

The main reason for this is the fear of resumption of the cycle, but the risk of bleeding is significantly reduced when taking new combined estrogen-progestogen drugs with the gonadomimetic tibolone, which are most suitable for older women.

The argument in favor of HRT may include a halving of mortality from cardiovascular disease and a reduction in the likelihood of developing Alzheimer's disease, but if an older woman does not agree to HRT, it is impossible to convince her otherwise.

A slight increase in the risk of developing breast and uterine cancer and venous thromboembolism precludes the use of HRT in women with a history of these diseases.

Raloxifene, a selective estrogen receptor modulator (SERM) that increases bone mass, has recently been licensed for the prevention of vertebral fractures [7].

This treatment probably reduces the risk of developing breast cancer, occasionally causing vaginal bleeding, but, unfortunately, the risk of venous thromboembolism remains, as with HRT. If it is shown to reduce the incidence of fractures in women with osteoporosis, it would be an excellent drug suitable for the elderly.

Alendronate sodium and etidronate are licensed for the treatment of osteoporosis and are often more acceptable to older women than HRT. They increase bone mass and reduce the incidence of vertebral and, in the case of alendronate, also hip and hand fractures [8]. The calcium supplement used in this case is not popular, so it makes sense to replace it with an alternative calcium preparation, the choice of which is quite large.

Occasionally, alendronate causes unpleasant digestive disorders, and sometimes there are reports of ulcerative lesions of the esophagus. It is important that the patient carefully follows the manufacturer's recommendations and takes the drug every morning at least 30 minutes before meals with a glass of water, and does not go back to bed until breakfast. Unfortunately, some women are unable to adhere to this regimen and thus resist treatment.

HRT and bisphosphonates form the mainstay of treatment for older women with osteoporosis, but some women cannot or do not want to take hormonal drugs or do not tolerate bisphosphonates. Other possibilities include calcitriol or calcitonin. Calcitriol occasionally causes hypercalcemia and monitoring of serum calcium levels is necessary when taking it. Calcitonin is currently only available in injectable form, which is inconvenient for patients, and the treatment is often associated with unpleasant side effects such as nausea and hot flashes.

Anabolic steroids and fluoride have been used in the past, but their results are very moderate and limited by side effects, so they are not recommended. Various other agents are also being studied in specialized departments.

• Fractures: prevention and treatment

The risk of future fracture increases fivefold in those patients who have already had minimal traumatic fractures. But this danger can be avoided by taking preventive measures and treating low bone mass as described above. A given patient's risk of fracture depends not only on bone mass and impact force, but also on the risk of falling.

E

This risk is determined by a number of factors (Table 2), which can generally be divided into those associated with impaired neuromuscular function and iatrogenic factors, such as the use of hypnotics and psychotropic drugs [2].

Table 2. Falls: risk factors

Previous falls Old age Weakness of the lower extremities Balance and gait problems Using walking aids Visual impairment Environmental Hazards Taking sedatives, hypnotics or psychotropic drugs

It is important to reconsider the need for regular use of such drugs and get rid of unnecessary ones. Regular exercise can help restore neuromuscular function, and in some cases physical therapy can help.

It is well known that most accidents occur at home, where the elderly spend most of their time. At home, dangers await an elderly person literally at every turn, for example, poor lighting, worn carpets, sagging electrical wires. Every effort should be made to convince patients and their families (which is usually more effective) to make their home safer.

High-risk patients, such as frail elderly people with a history of fractures, can wear hip protectors, which reduce the risk of fractures with regular use. Unfortunately, patients do not always agree to wear them, and at times of greatest risk, such as when a patient gets out of bed at night and goes to the bathroom, the protector is usually not in place.

For patients with vertebral fractures, an appropriate analgesic is selected, while care is taken to avoid excessive sedation so as not to increase the risk of falls.

Pain in general can be a significant problem in these patients, but using calcitonin at a daily dose of 100 IU for 3 to 8 weeks can provide significant relief.

Early mobilization is encouraged to reduce bone loss and support neuromuscular function.

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Who should be sent to the hospital? To some extent this depends on local capabilities. It makes sense to refer to a specialist patients with intolerance to HRT and bisphosphonates, as well as those whose height is noticeably reduced, kyphosis progresses, as well as bone fragility and the incidence of fractures increases, despite treatment.

Patients with secondary osteoporosis due to other diseases sometimes require referral to an appropriate specialist.

Physical and/or occupational therapy may also be helpful in improving neuromuscular function and reducing the risk of falls.
A recent randomized trial of people treated with this therapy for a fall found that the risk of subsequent falls was significantly reduced after taking it. References 1. NIH consensus development conference. Diagnosis, prophylaxis and treatment of osteoporosis // Am. J. Med. 1993; 94: 646-650. 2. Quick reference primary care guide on the prevention and treatment of osteoporosis // Department of Health, June 1998. 3. Kanis JA, Melton LJ, Christiansen C., Johnston CC, Khaltaev N. The diagnosis of osteoporosis // J. Bone Min. Res. 1994; 8: 1137-1141. 4. Hosking D., Chilvers CED, Christiansen C. et al. Prevention of bone loss with alendronate in postmenopausal women under 60 years of age // N. Engl. J. Med. 1998; 338:485-492. 5. Chapuy MC, Arlot ME, Duboef F. et al. Vitamin D and calcium to prevent hip fractures in elderly women // N. Engl. J. Med. 1992; 327:1637-1642. 6. Marx CW, Dailey GE, Cheney C., Vint VC, Muchmore DB Do estrogens improve bone mineral density in osteoporotic women over age 65 // J. Bone Min. Res. 1992; 7: 1275-12 79. 7. Delmas PD Bjarnason NH, Mitlak BH et al. Effects of raloxifene on bone mineral density, serum cholesterol concentrations and uterine endometrium in postmenopausal women // N. Engl. J. Med. 1997: 337: 1641-1647. 8. Black DM, Cummings SR, Karpf DB et al. Randomized trial of effect of alendronate on risk of fracture in women with existing vertebral fractures // Lancet 1996; 348:1535-1541.

Note!

• The following diseases lead to the development of osteoporosis: prolonged premenopausal amenorrhea, oophorectomy, early menopause, hyperparathyroidism, hyperthyroidism, malabsorption syndrome, chronic liver and kidney diseases, prolonged immobilization and steroid use
• According to dual energy X-ray absorptiometry (DXA), a decrease in bone mass of more than 2.5 standard deviations from its highest value indicates osteoporosis, and a mass value between 1 and 2.5 deviations below its highest value is defined as osteopenia
• Clinical manifestations of osteoporosis at the height of the disease are reduced to severe kyphosis, characterized by decreased height, sagging of the abdomen, associated with the fact that the lower ribs cover the iliac crests. Most patients who experience a minimally traumatic fracture of the femur or vertebrae also suffer from osteoporosis
• Regular exercise and adequate calcium intake along with vitamin D help maintain bones. It is recommended that adults take at least 700 mg of calcium and 400 IU of vitamin D daily throughout their lives.
• Hormone replacement therapy prevents osteoporosis; According to some data, five years of taking replacement drugs reduces the incidence of fractures by 25-50%, and ten years - by 50-75%. Unfortunately, bone loss resumes when treatment is stopped, and any beneficial effects of therapy on bone are quickly lost
• The mainstay of treatment for older women with osteoporosis is HRT and bisphosphonates, but some women cannot or do not want to take hormone replacement drugs, and others do not benefit from bisphosphonates. Other therapeutic options include raloxifene, calcitriol and calcitonin.

Diagnosis of osteoporosis

The most effective tool for diagnosing osteoporosis is bone densitometry. Densitometry can determine bone mineral density and predict the risk of fractures. This test plays an important role in identifying osteoporosis at an early stage, when there are no fractures yet. Densitometry makes it possible to make a diagnosis with a loss of only 3-5% of bone tissue, and the serious consequences of osteoporosis in the form of bone fragility and fractures begin after a loss of 20-30%.

In addition to densitometry, the doctor conducts a physical examination of the patient, including measuring height and comparing it with growth at a young age, checking for the presence of thoracic kyphosis, measuring body mass index, and also prescribing a clinical blood and urine test.

Preventive nutrition

Avoid strict diets and rapid weight loss. Despite the fact that maintaining an optimal weight is a good prevention of osteoporosis, sudden weight loss leads to a decrease in bone density
. In addition, when women rapidly lose weight, their menstrual cycle is often disrupted, which can lead to earlier development of osteoporosis due to a lack of the female hormone estrogen.

Eat a varied diet and do not forget about the balance of vitamins and minerals in your diet.

Avoid foods that are excessively rich in phosphorus and phosphates
, which form insoluble compounds with calcium in the intestines and prevent it from entering the bloodstream. There is a lot of phosphorus in red meat, smoked and processed meat products, as well as in carbonated drinks. Avoid tobacco, alcohol and excess coffee. They interfere with calcium absorption. Carefully monitor the condition of the gastrointestinal tract. Chronic gastritis, pancreatitis and cholecystitis reduce calcium absorption by up to 80 percent.

Treatment of osteoporosis in older people

Based on the research results, the doctor will prescribe an individual treatment plan. Effective treatment includes taking medications, as well as non-drug methods - physical therapy, recommendations for lifestyle changes, diet, and exercise. When prescribing medications to older patients, the physician must evaluate their benefits and risks, since older people are more likely to experience complications from taking medications and, as a rule, already have a history of several chronic diseases and drug therapy associated with them.

The main goals of treatment are to slow down the destruction of bone tissue and stimulate the formation of new one, reduce the risk of falls and fractures, and improve the physical condition and activity of an elderly person. For elderly patients, an important component is non-drug treatment - lifestyle changes, giving up bad habits, proper nutrition, and moderate physical activity. If there is a high risk of fractures, the doctor may recommend wearing special corsets or orthoses.

Drug therapy includes complex preparations of calcium, other minerals and vitamin D, drugs that promote the formation of new bone tissue and drugs that slow down its destruction.

The most beneficial exercise for older people is walking, regular walks in the fresh air, and balance exercises. Active sports, which can cause injuries and falls, are not recommended.

Elderly people often do not attach due importance to proper nutrition, eat familiar, not always healthy foods, and do not get the required amount of calories. For older patients with osteoporosis, it is important to get enough calories, vitamins and microelements.

Prevention movement

Many studies show that physical activity is an effective way to combat osteoporosis. With regular loading, bones become stronger
, since the saturation of bone tissue with calcium also depends on the condition of muscle tissue.
Choose physical activity that evenly loads all muscle groups: dancing, swimming, running, aerobics. Combine muscle training with exercises that develop balance and coordination: exercises on a fitball or push-ups. This will allow you to avoid falls
and, as a result, fractures in the future. Always follow the recommendations of doctors and sports instructors - the load should be strictly dosed, increase gradually, and exercises should be performed correctly to avoid injuries.

Proper nutrition for osteoporosis

• Eating foods rich in calcium and vitamin D: milk, yogurt, cheeses, white and river fish, eggs, green vegetables (broccoli, celery), salad, herbs, fruits (orange), halva, nuts (sesame, almonds), tofu, dates.
• Limiting the consumption of foods that cause calcium removal from the body: salt, carbonated drinks, coffee, chocolate, alcohol, red meat and smoked meats.
• Balanced intake of proteins and fats: a low-protein diet contributes to poor absorption of calcium, and increased consumption of protein foods leads to increased excretion of calcium in the urine; with a deficiency of fat, the absorption of vitamin D is reduced, and with a significant excess of fat, the absorption of calcium is reduced.

Prevention methods: exercises to prevent osteoporosis, pills, diet

Physical activity

Let's start with recommendations for gymnastics to prevent osteoporosis, and give the basic exercises.

Important! All training should begin with a low load, gradually increasing it, but not leading to excessive load.

Weight-bearing exercise strengthens bones because it stimulates the cells responsible for mineralization and bone production. They are called osteoblasts. There are a lot of exercise options - these are team sports, running, walking, aerobics, swimming, exercise equipment, cycling, exercises with elastic bands and dumbbells, Nordic walking, swimming. If these types of activities are not suitable for you, you can do gymnastics at home by choosing several exercises from those described below. The most important thing is regularity; you need to do the exercises every day.

Foods and vitamins for the prevention of osteoporosis and general principles of nutrition

You need to consume enough calcium and vitamin D, which allows it to be better absorbed. Phosphorus, magnesium, copper, and boron are also important for bones.

The healthiest foods are pork, beef, cod liver, dairy and fermented milk products, homemade cheeses, fatty fish, any greens, sprouted grains. Soy is important for women because it contains phytoestrogen, a plant analogue of estrogen.

The main sources of calcium are salmon, green vegetables and fruits, white cabbage, skim milk and yogurt. Calcium-fortified orange juice, which is also rich in vitamin C, is doubly beneficial.

Important! Salt, alcohol and caffeine lead to the leaching of calcium and a number of other important substances. They should be kept to an absolute minimum.

Vitamin D levels can be maintained by walking for 30 minutes every day in mild sunlight. However, in our latitudes this is not always possible. Therefore, you need to eat foods rich in this vitamin and/or include supplements in tablet form. This could be “Calcium D3 Nycomed”, “Ultra-D”, etc. Food sources of vitamin D are egg yolks, cod liver, fatty fish, fortified milk.

It is necessary to include sources of vitamins A, C, K, as well as group B, and folic acid in the diet.

You should not abuse protein, because it disrupts the absorption function in the gastrointestinal tract and provokes fermentation processes. The daily norm is 100-150 g.

It is necessary to exclude or minimize sweet and/or carbonated drinks, packaged juices, vinegar, sour vegetables, fruits, berries, sorrel, rhubarb, spinach, sugar and salt, grain and instant coffee. It is important to maintain a balance of vitamin C, because its excess is also harmful.

Preparations and vitamins for prevention

Medicines and vitamin complexes should be prescribed by a doctor. Self-prevention can even be harmful, because by taking one, you can upset the balance of the other.

For prevention, vitamin D is prescribed (recommended daily dose is 400 IU), calcium supplements, thiazides, bisphosphonates, and HRT. When prescribing any medication, dosage is important because too much of anything is just as harmful as too little.

If there has been a long course of glucocorticosteroids, Risedronate may be prescribed, which is also indicated for menopausal women. It is a bisphosphonate that slows or stops bone loss by increasing bone density. In the postmenopausal period, the doctor may prescribe Raloxifene. This is a new generation preventive drug that has a beneficial effect on calcium metabolism and bone mass.

Preventive medical examinations

It is necessary to regularly, once a year, do ultrasound or X-ray densitometry. This is the most informative, fast and comfortable study. X-ray technique is indicated for examining the femoral neck, spine, and radius. It detects hidden fractures using a whole body scan.

It is necessary to donate blood once a year for calcium, especially during therapy with hormones and glucocorticosteroids.

General recommendations for a healthy lifestyle

You need to maintain an adequate level of physical activity, do gymnastics, and walk more. Nordic walking is very useful. The best form of prevention is swimming.

You should stop smoking or reduce the number of cigarettes you smoke by at least half. You can drink alcohol, but not much. Maximum – a glass of wine per day or 50 ml of strong drink. Coffee is also limited to 1 or 2 cups per day. At the same time, compared to other caffeine-containing drinks, including black tea, you should completely avoid coffee.

It is important to maintain a normal weight, eat at least 500 g of fresh vegetables and fruits per day, focusing on those rich in calcium, vitamin D, A, C, K.

Elderly people must be prevented from falling. For this purpose, it is even worth discussing with your doctor the possibility of discontinuing medications that cause dizziness.

How to prevent osteoporosis yourself?

Calcium must be supplied to the body throughout life (from childhood to old age), because it is the main component of bone tissue. This useful microelement is extremely important for the prevention of osteoporosis. If the body's need for calcium has been fully satisfied during the period of active bone growth, then maximum bone mass is created. Human bones contain 98% of the calcium found in the body, the remaining 2% is used for other vital body functions. Therefore, bones also provide the function of a depot, from which the necessary amount of calcium is supplied to the body’s needs. The microelement begins to be washed out of bone tissue if insufficient calcium is supplied through food, which can ultimately cause a disease such as osteoporosis.

In order to make sure that your body is getting enough calcium, you need to know the daily requirement for each age.

This table shows the body's daily requirement for calcium:

Calcium can be obtained from food:

• Dairy foods (cheese, cottage cheese, milk, cream) - about 80% of calcium is consumed through such products;
• Greens (spinach, parsley);
• Vegetables;
• Legumes (beans);
• Cabbage (cauliflower, broccoli);
• Onion;
• Bean curd;
• Fruits (apples, pears);
• Dried apricots;
• Juices;
• Eggshell;
• Seafood;
• Nuts, seeds, almonds.

The best foods for absorption are:

• Fish;
• Beans;
• Eggs (shell);
• Cabbage, spinach, celery, parsley;
• Cottage cheese;
• Apricots;
• Grape;
• Currant;
• Oranges and pineapples.

These products contain not only calcium, but also vitamins B, C, D and phosphorus.

Dark green, leafy vegetables contain high levels of calcium, but calcium absorption is slowed by oxalic acid. Foods containing a lot of calcium and a small amount of oxalic acid include:

• Turnip;
• White cabbage;
• Broccoli.

The body absorbs 20-40% of calcium. The absorption process is negatively affected by excessive levels of potassium, magnesium and phosphorus, as well as deficiency or excess fat in the body.

Despite the fact that most microelements come to us through dairy products, approximately 40% of the population (both children and adults) are contraindicated to drink milk, since their body stops digesting lactose. For such people, the prevention of osteoporosis will include fermented milk products, as well as other foods that are rich in calcium.

Content

• Causes of osteoporosis in the elderly
• Symptoms of osteoporosis in older people
• Degrees of development of the disease and their diagnosis
• How to treat osteoporosis in older people?
• Prevention of osteoporosis in older people

Decreased bone density is found in approximately 33% of women and 26% of men over 50 years of age1.
Calcium loss is the main cause of osteoporosis in old age. It is one of the most common non-communicable diseases in the world. With age, the likelihood of osteoporosis increases in older women and men1. With osteoporosis, fractures occur even from minimal impact. These are so-called “low-energy injuries” and most often occur in the radius, humerus, femoral neck, and vertebral bodies. In Russia, osteoporotic fractures of the femoral neck are registered in 18% of women and 6% of men over the age of 50 years2. The mortality rate due to such fractures ranges from 30.8 to 35.1%3.

The dangerous consequences of fractures in older people can be prevented through early diagnosis, prevention and adequate treatment of osteoporosis.

Why is it important to detect osteoporosis early?

Osteoporosis in older people is dangerous due to the high risk of bone fractures, in particular hip fractures. Moreover, after the age of 65, the hip cannot be completely restored, which, as a rule, leads to disability, and in some cases to death.

In addition to a high risk of fractures, the disease leads to kyphosis of the chest and curvature of the spine. In both cases, displacement of internal organs occurs, as well as pathological processes that cause compression of the roots of the spinal nerves.

Such manifestations contribute to the development of a number of diseases that are dangerous due to their course and complications. The earlier the diagnosis is made, the higher the likelihood of avoiding complications.

Calcium supplements for the prevention of osteoporosis in women

If a person does not receive enough calcium from food, it is recommended to add drugs that contain calcium or food supplements with this microelement to the diet.

It is important not to forget that not only an insufficient amount of calcium is dangerous for the body because it causes osteoporosis, but its excessive content can also harm a person, causing the formation of stones in the kidneys, urinary and gall bladder, and negatively affects the cardiovascular system, as well as provokes the early onset of gout and arthritis.

Pharmaceutical companies produce a wide variety of different medicines that contain calcium as the main ingredient or as an additive in combination preparations. Before purchasing any medications, you should definitely consult with your doctor, who will select the most suitable drug for the prevention of osteoporosis, calculate the dosage, and also tell you the time of administration. This is due to the fact that some drugs need to be taken once a day, while others need to be taken several times, and their intake may depend on food intake.