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Healthy Living

Seniors and Aging - Osteoporosis

It's Your Health

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The Issue

Osteoporosis is a loss of bone density among aging adults that can cause painful fractures, disability and deformity. While heredity and bone size affect the development of osteoporosis, it is often possible to prevent, delay or reduce bone loss through healthy living.

Background

Osteoporosis affects both sexes but is more frequent among women. It is estimated that about one out of four women and one out of eight men over the age of 50 in Canada have osteoporosis.

Bones are constantly being renewed naturally. But with age, this process becomes less efficient, and bone mineral density is lost. When bone mineral density is lower than normal, but not low enough to be classified as osteoporosis, it is called osteopenia. Osteoporosis causes bones to become very thin and weak over time and increases the risk of fracture. It is often called "the silent thief" because bone loss occurs without symptoms.

When bones are seriously weakened by osteoporosis, even simple movements such as bending over to pick up a bag of groceries or sneezing heavily can lead to fractures.

Health Effects of Osteoporosis

Wrist, spine and hip fractures are most commonly associated with osteoporosis. Bone fractures occurring in these areas resulting from a fall from standing height or less are called fragility fractures, and are evidence of osteoporosis.

Hip fractures due to osteoporosis are a serious problem for seniors. Mortality is significantly increased after hip fracture, and fewer than 50 % suffering from this injury experience functional recovery, and many are permanently disabled. About 25 % of patients reside in long-term care facilities for a year or more after a hip fracture.

There usually are no warning signs for osteoporosis until a fracture occurs. However, there are ways to help prevent, delay and treat osteoporosis.

Risk Factors for Osteoporosis

Women are especially at risk of osteoporosis. At menopause, estrogen levels, which help keep women's bones healthy, drop dramatically. Many women experience more bone loss during menopause.

Hormone replacement therapy can help reduce the drop in estrogen levels during menopause, preventing and even correcting bone loss. However, there may be adverse health effects, including an increased risk of breast cancer. Talk to your doctor about what might be suitable for you.

Although men usually have a greater bone mass than women, they can also suffer from osteoporosis.

In addition to age, there are several factors that will increase your risk of developing osteoporosis. They include:

  • a family history of osteoporosis
  • osteopenia
  • low body weight
  • a diet low in calcium
  • low levels of physical activity
  • ovaries removed or early menopause (before the age of 45), without hormone replacement
  • being past menopause
  • vitamin D deficiency
  • smoking
  • excessive caffeine intake (more than four cups a day of coffee, tea or cola) or excessive alcohol intake (more than two drinks a day)
  • long-term oral use of some medications such as cortisone, prednisone or anticonvulsants

Minimizing Your Risk

If you have some of the risk factors listed above, talk to your doctor about getting a bone density test and take preventive action to reduce the risk. Here are some of the things you can do to protect your bones.

  • Eat well. All Canadians are encouraged to eat well and to be active every day by following the advice contained in Eating Well with Canada's Food Guide to reduce their risk of chronic diseases such as osteoporosis.
  • Include calcium in your diet. People over the age of 50 need 1200 mg of calcium each day. As you age, your body doesn't absorb calcium as well, so calcium rich foods are important and you may require a calcium supplement. Calcium rich foods include milk and milk products; salmon and sardines with bones; beans; sunflower and sesame seeds; broccoli and other greens; figs; and rhubarb.
  • Get enough vitamin D. Calcium is not easily absorbed by the body without vitamin D. In addition to following Canada's Food Guide, which recommends that all Canadians over the age of two consume 500 mL (two cups) of milk every day, everyone over the age of 50 should take a daily supplement of 400 IU of vitamin D. People who do not drink milk or fortified soy beverage will most likely require a supplemental source of vitamin D. For a large part of the year in Canada (October to March, and longer in far northern latitudes) the sun is not strong enough to produce vitamin D in the skin. The skin also has reduced capacity to produce vitamin D as it ages.
  • Be active every day. Bones become stronger with increased activity. Include regular weight-bearing exercise such as dancing, walking, hiking or tennis in your daily routine. Exercise that improves balance and coordination such as yoga, tai chi swimming and flexibility exercises will help reduce falls and prevent fractures. Try several activities until you find the one that's right for you.
  • Avoid smoking. Smokers have faster rates of bone loss and a higher risk of fractures than non-smokers. Women who smoke also tend to enter menopause at an earlier age than non-smokers. This means more rapid bone loss takes place at an earlier age.
  • Prevent falls. If you have been diagnosed with osteoporosis or have some of the risk factors, preventing falls is particularly important. An exercise program geared to your abilities will help. Wear comfortable shoes that give good support. Watch for uneven ground, sidewalks and floors. Don't rush to catch a bus, answer the phone or a doorbell. Make your house safe to reduce the risk of accidents. See the Need More Info? section below and get your copy of The Safe Living Guide.

If you have already been diagnosed with osteoporosis or osteopenia, talk to your doctor about medication that may help with your condition.

Some people with osteoporosis suffer pain from a fracture or chronic pain due to compression or muscle spasms. Your doctor can help you find the right pain relief for your symptoms and possibly recommend other therapies which may help including ice and heat, relaxation therapy, acupuncture and other alternative ways of dealing with pain.

Government of Canada's Role

Health Canada and the Public Health Agency of Canada are committed to helping Canadians improve their the health and well-being by promoting and supporting regular physical activity and healthy eating.

In particular, the Public Health Agency disseminates information on healthy aging and encourages seniors' health promotion, risk reduction and stabilization of chronic conditions, such as osteoporosis.

The Agency also works with stakeholders at all levels to provide leadership in chronic disease prevention and control. It does this through its policy and program development, surveillance and educational development.

Need More Info?

For more information on osteoporosis, contact the following:

Public Health Agency of Canada Next link will take you to another Web site Osteoporosis Info Sheet for Seniors.

For more on Eating Well with Canada's Food Guide

To order a copy of Next link will take you to another Web site The Safe Living Guide or call (613) 952-7606

Next link will take you to another Web site Osteoporosis Canada at 1-800-463-6842 or (416) 696-2663 in Toronto

The Next link will take you to another Web site Arthritis Society at 1-800-321-1433

Public Health Agency of Canada's Next link will take you to another Web site Centre for Chronic Disease Prevention and Control.

For additional articles on health and safety issues go to the It's Your Health Web site
You can also call toll free at 1-866-225-0709 or TTY at 1-800-465-7735.

Original: March 2007
Updated: October 2007
©Her Majesty the Queen in Right of Canada, represented by the Minister of Health, 2007