We often hear of elderly people, sometimes even younger ones, suffering a fracture from a low impact injury or fall. This is because progressive bone depletion has made their bones too weak to tolerate even a slight injury. High risk of fractures is a major concern for people living with osteoporosis. Once a patient suffers an osteoporosis-related fracture his or her risk of a future fracture increases up to 10 times. Around 25 per cent of patients who sustain a hip fracture die within a year, and less than half of those who survive to regain their previous level of function.
Bone depletion or osteoporosis is a common phenomenon experienced with ageing that makes people extremely prone to fractures. With rising life expectancy, the incidence of osteoporosis is on the rise in India, so is the risk of bone fractures associated with brittle bones. This extreme thinning of bones can now be arrested, thanks to a new line of treatment called denosumab – an osteoporosis medication for people who are at high risk of fractures.
While there is limited data available on osteoporosis prevalence in India, it was estimated by a study in 2013 that around 50 million people in India were either osteoporotic or had low bone mass. A UN Population Projection for India suggests that 306,000 hip fractures occurred in 2015. In a study among Indian women aged 30–60 years from low-income groups, bone mineral density (BMD) at all skeletal sites was much lower than values reported from developed countries, with a high prevalence of osteopenia (52 per cent) and osteoporosis (29 per cent), thought to be due to inadequate nutrition.
As we age, bone mass or density is lost. This phenomenon is termed as Osteoporosis which happens in both sexes but especially aggravates in women after menopause. In extreme cases, they become abnormally porous and fragile and extremely susceptible to fractures. The course of treatment involves prescribing calcium, vitamin D supplements to patients and bisphosphonates and teriparatide drugs. A new class of drug called Denosumab is also now available in India. One denosumab injection every 6 months helps arrest bone loss in patients at high risk of fracture. It slows down the natural rate of bone depletion and allows people with osteoporosis to lead a normal life.
Essentially bone density is at its peak till 35 years and thereafter it starts decreasing. Bones naturally start becoming thinner with age as the rate of depletion of the bone outstrips the rate at which new bone is made. The bones lose calcium, other minerals, and mass, making them week. Rampant vitamin D deficiency and inadequate calcium intake in younger people is aggravating the incidence of osteoporosis. With improper diets, fault lifestyles and absence of sun exposure, a large part of our population including relatively younger adults are falling prey to osteoporosis.
With increasing life expectancy, the prevalence of osteoporosis is on the rise. At the same time, Vitamin D deficiency is rampant among Indians today and contributes heavily to poor bone health. The lifestyles that prevent us from sun exposure and the habit of applying sunscreen further hampers the production of Vitamin D. It is essential for every individual to expose a substantial part of their skin to the sun everyday for at least 15-20 minutes.
It is important to educate people, especially young women to stay physically active with regular weight-bearing exercises and outdoor activities to ensure sound bone health. It is equally important to avoid reckless weight loss diets that may put you at high risk of nutritional deficiencies. It is also advisable to increase the intake of calcium-rich foods such as dairy products to prevent osteoporosis.