Osteoporosis: Protecting Your Bones as You Age

Bone is made up of a combination of collagen, bone cells, and calcium. The calcium gives bone its hardness and strength. Despite that hardness, bone is not a static tissue — it is constantly being absorbed and rebuilt through a process called remodeling. Our bones are strongest in our late 20s; after that, although remodeling continues, the process slows and bone gradually loses strength. The quality, or strength, of bone is reflected in its density.

How osteoporosis is measured

A bone density study — a dual-energy X-ray absorptiometry, or DEXA scan — measures the strength of bone. Bone with low density is said to have osteoporosis and is at increased risk for fractures. Osteoporosis means there is simply less bone tissue and calcium; the quality of the remaining tissue is the same, but there is less of it.

Who is at risk, and who should be screened

While many conditions can cause osteoporosis, certain people — such as post-menopausal white women — are at increased risk as they age. General screening guidance:

• Post-menopausal women over 65 should be screened routinely, regardless of risk factors.
• Women 60–65 with increased risk should also be screened routinely.
• There is no firm recommendation to test women under 60, or women 60–65 without increased risk — though some feel every post-menopausal woman should have a baseline study.

Once treatment has started, the test can generally be repeated about once every two years. For patients not yet diagnosed with osteoporosis, a repeat study in one to two years is often recommended.

Treatment

If a bone density study shows osteoporosis, treatment should begin. Several options exist, and each patient's situation determines what works best. Common medications include Fosamax, estrogen, and calcitonin, usually combined with increased calcium intake. These treatments aim to keep bone density stable or slow the process — but they cannot reverse osteoporosis. That's why early diagnosis and prompt treatment matter so much.

Why it matters: fractures

The goal of treatment is to keep bones strong enough to prevent fractures. Common fractures in osteoporotic patients include compression fractures of the spine, wrist fractures, and hip fractures — often after only a minor fall. These fractures, especially of the hip, pose serious health risks and can make it very difficult for patients to function.

Prevention

Preventing osteoporosis focuses on adequate nutrition, calcium, vitamin D, exercise, maintaining a healthy weight, and smoking cessation.