Keeping Bones Strong as We Age

From the time we are born, our bone tissue is continually being replaced through a process called bone remodeling. In our mid-20s, we reach peak bone mass, which stays fairly stable until we hit our 40s. At that point, bone cells start to die faster than replacement cells can be produced. 

For women, bone loss increases after menopause and for men, around age 65 or 70, allowing for deterioration and weakness. This aging process is accelerated by osteoporosis, which causes the bones to become thinner, more brittle and subject to breaks during a fall.

Who’s At-Risk

Like hypertension and diabetes, osteoporosis is often referred to as one of the silent diseases because low bone density can go undetected until a broken bone brings the issue to light. Although this condition generally affects women at far greater rates than it does men, many non-gender specific lifestyle and health factors can increase your risks. Some include:

• Diet, including increased levels of caffeine, salt and alcohol 

• Lifestyle choices such as smoking and inactivity

• Vitamin deficiencies, including vitamin D and calcium

• Adverse reactions to medications such as corticosteroids or anticonvulsants

• Medical issues, including autoimmune diseases and diabetes

A quick online test offered by the International Osteoporosis Foundation also can help you determine if you are at higher risk.

How Osteoporosis Is Diagnosed 

If you have any heightened risk factors for bone loss or a fracture and are 50 years of age or older, consider visiting your healthcare professional for a thorough diagnosis. Even without risk factors, women who are 65 and men who are 70 should get a bone mineral density test (BMD).

 The most commonly used BMD method is the simple DXA test, a low radiation X-ray capable of detecting very small percentages of bone loss. Where standard X-rays can recognize bones that have been broken, the DXA provides you with a score that enables you to monitor your bone health before a break might occur. 

What Type of Treatments Are Available

If your test results indicate low bone mass or osteoporosis, several treatments are available to slow the disease’s progression and help you avoid injury. These can be considered along with healthy lifestyle changes.

Vitamin supplements. A simple first step, calcium is the most essential mineral in maintaining bone mass, as well as promoting nerve and muscle function. While the Endocrine Society recommends adding calcium via diet or supplements as a supportive treatment, this alone will not solve the problem of low bone mass. Vitamin D also is integral for absorption of calcium. It is important to take the recommended daily amounts of both calcium and vitamin D to help minimize health complications such as kidney stones.

Exercise. Science has shown that bone cells respond to conventional weight training by becoming both stronger and harder. The key to including exercise as a treatment to osteoporosis is to facilitate natural bone growth without increasing injury risk. A knowledgeable physical therapist can help assess your level of fitness and help design a safe and effective exercise program. Exercise is important for balance and to decrease risk of falls that might result in fractures.

Pharmaceutical therapy. The cells responsible for the removal of old bone are called osteoclasts. Bisphosphonate pharmaceuticals, whether administered as a pill or intravenously, work by reducing osteoclast activity, reducing the turnover of bone or removal of old bone and helping preserve bone density and strength. This treatment has proven highly effective but, as with all medicines, it too comes with risks. When administered under the watchful eye of your physician, however, these can be minimized.

While there is no cure for brittle bones or osteoporosis, there are active steps you can take to prevent and treat it. By doing so now, you can help minimize its repercussions and keep your bones — and lifestyle — going strong.