The Age of Osteoporosis—Part 1

Osteoporosis, or the thinning of the bone, is becoming a household term. Especially as our population ages, we are seeing more and more of the negative effects of osteoporosis.    As you can imagine, as the bone thins out, it becomes weaker.  As a result, less forceful events can lead to a fracture, or broken bone.  Whereas a teenager may fall off a bike or a skateboard numerous times, they only infrequently break a bone.  On the other hand, a simple stumble and fall in grandma or grandpa may cause a wrist, hip, or shoulder fracture, for example.  We’ve also noted how our grandparents become shorter and more hunched over as the vertebrae in their spines collapse and compress.  This is osteoporosis rearing its ugly head.

Chances are you’ve seen a bone at some point in your life whether it is from a piece of steak or a chicken bone, or perhaps even a treat for your dog.  In general, bones have a thick, hard outer layer called the cortex.  In your thigh bone, or femur, the cortex is thickest in the middle of the thigh and thinner at the ends near the hip and knee.  The inner layer is cancellous bone.  Often called spongy bone, it is very porous like a sponge.  This bone is more prevalent at the ends of the bones where the cortex is thinner.  As we get older our bones become less dense.  It would be like taking swiss cheese and making the holes bigger, essentially leaving you with less cheese, or in this case, less bone.

As the bone thins out, the most susceptible areas for fracture are the ends of the bone where the cortex is thin and the spongy bone is predominant.  This is why hip, shoulder, wrist, and knee fractures are so common in our aging population.  Unfortunately, unlike the teenager who may return to school the next day with a cast after breaking their wrist, a hip fracture is an extremely life changing event.  These patients require surgery to help fix their hip to try to get them moving again.  But getting back to normal is hard.  Fifty percent of seniors will lose a level of function after a hip fracture, meaning, whereas they may not have needed a cane or walker prior to the injury, they will afterwards.  Even more eye-opening, the mortality rate at one year after a hip fracture is over 20% according to various reports and can be over 50% if the person has dementia.  These numbers are alarming.

Unfortunately, an osteoporotic fracture is bound to affect you or a loved one.  Fortunately, medical research is giving us the ability to fight back.

 

Written by  Dr. Brimacombe, MD 

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