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Osteoporosis

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Geriatric Condition:

Osteoporosis

Osteoporosis in geriatrics refers to a condition characterized by weakened bones in older adults, increasing the risk of fractures. It occurs when bone density and quality decrease, making bones more fragile and susceptible to breaks, especially in the hip, spine, and wrist.

Types
  • Primary Osteoporosis:
    • Type I (Postmenopausal Osteoporosis): Occurs in women after menopause due to decreased estrogen levels.
    • Type II (Senile Osteoporosis): Occurs in both men and women over the age of 70 due to aging.
  • Secondary Osteoporosis: Caused by other medical conditions or medications that affect bone health, such as glucocorticoid use, hyperthyroidism, and rheumatoid arthritis.
Symptoms
  • Bone Fractures: Increased susceptibility to fractures, particularly in the hip, wrist, and spine, often with minimal trauma.
  • Back Pain: Chronic pain due to vertebral fractures or collapsed vertebrae.
  • Loss of Height: Noticeable reduction in height over time due to spinal compression fractures.
  • Stooped Posture: A forward-hunched posture, also known as kyphosis, resulting from spinal bone loss.
Causes
  • Age-Related Changes: Natural bone loss associated with aging.
  • Hormonal Changes: Decreased estrogen levels in women post-menopause and decreased testosterone levels in aging men.
  • Nutritional Deficiencies: Insufficient intake of calcium and vitamin D, which are critical for bone health.
  • Sedentary Lifestyle: Lack of weight-bearing and muscle-strengthening exercises that promote bone health.
  • Medical Conditions: Diseases such as hyperthyroidism, chronic kidney disease, and rheumatoid arthritis.
  • Medications: Long-term use of corticosteroids, anticonvulsants, and certain cancer treatments that affect bone density.
  • Genetics: Family history of osteoporosis increases the risk.
Impact To Lifestyle
  • Reduced Independence: Increased risk of fractures can lead to decreased mobility and dependence on others for daily activities.
  • Chronic Pain: Persistent pain from fractures, particularly in the spine, which can affect daily functioning and quality of life.
  • Limited Mobility: Fear of falling and sustaining fractures can lead to reduced physical activity.
  • Emotional Health: Anxiety, depression, and social isolation due to fear of fractures and reduced mobility.
  • Increased Healthcare Needs: More frequent medical appointments, treatments, and potential hospitalizations due to fractures.
Management & Prevention
  • Medical Management: Use of medications such as bisphosphonates, hormone replacement therapy (HRT), and calcium and vitamin D supplements to strengthen bones.
  • Physical Therapy: Exercises tailored to improve bone density, muscle strength, balance, and coordination.
  • Weight-Bearing Exercises: Regular physical activities such as walking, dancing, and weight training to maintain bone health.
  • Nutritional Support: A diet rich in calcium and vitamin D from dairy products, leafy greens, and fortified foods, along with supplements if necessary.
  • Lifestyle Modifications: Avoiding smoking and excessive alcohol consumption, both of which can negatively affect bone health.
  • Fall Prevention: Making home modifications to reduce fall risks, such as installing grab bars, removing tripping hazards, and ensuring adequate lighting.
  • Bone Density Monitoring: Regular bone density tests (DEXA scans) to monitor bone health and detect early signs of osteoporosis.
  • Education and Support: Participating in osteoporosis education programs and support groups to learn more about managing the condition and connecting with others facing similar challenges.
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