Did you know your bones are a living tissue? They need regular exercise to build strength, just like your muscles. A healthy balanced diet and active lifestyle can set you up for better bone health as you age.
This is important because a third of people aged over 65 fall every year, with six percent of those falls causing a fracture that may lead to long-term pain and reduced independence.
At Springs Medical, our doctors, nurses and allied health staff are here to support you in taking action to maintain healthy bone density and reduce your risk of falls. Your GP can assess your bone health risk factors and refer you to have a bone density scan if appropriate.
We also arrange for the MeasureUp Bone Density Bus to visit our Clinics to make it easier for patients who need to have their bone density monitored regularly. We will advertise when the bus is next due ahead of time so you can book in.
Bone fractures in the elderly are mostly due to osteoporosis, and typically involve the spine, wrist and hip bones.
Osteoporosis is a disease where bone structure becomes weaker and less dense, with an increased risk of breaks. The word osteoporosis has Greek origins and means porous bones.
With severe osteoporosis, your bones may become so fragile that they may fracture spontaneously or with a minor stress such as bending or coughing. After the break heals, you may experience chronic pain and a decreased ability to carry out your normal daily activities. You are now also at higher risk of more fractures.
While looking after your bones throughout your life is important, some people are at increased risk of osteoporosis because of their family history, gender, age, medical conditions, medications and lifestyle habits.
Osteoporosis has been called a ‘silent’ disease because typically it has no symptoms and you may be unaware your bones are fragile until you break a bone.
Osteopenia is a less severe bone condition than osteoporosis, where slightly lower bone mineral density is usually diagnosed by a DEXA (Dual-Energy X-ray Absorptiometry) scan. Not everyone with osteopenia will develop osteoporosis, but it’s a warning signal to take action to reduce your risk of osteoporosis.
Risk factors for developing osteoporosis include:
- gender. Being a woman, especially post menopause. Men are at greater risk when aged 70 +.
- age. Human bone density peaks between 25 and 30 years of age. Bone loss then occurs more quickly and bone growth slows.
- body size. Slender, thin-boned people are at greater risk because they have less bone to lose.
- family history. Your risk may be higher if your parents have osteoporosis or have had a hip fracture.
- hormone levels. Low oestrogen levels post menopause in women and low testosterone levels in men
- diet. An inadequate intake of dietary calcium and low vitamin D levels
- certain medical conditions and treatments, such as:
- endocrine and hormonal diseases
- thyroid disease
- diseases that affect the body’s ability to absorb nutrients such as Crohn’s disease, coeliac disease and other inflammatory bowel conditions.
- rheumatoid arthritis
- some cancers
- anorexia nervosa
- chronic liver and kidney disease
- surgical removal of the ovaries
- certain medications. Long-term use may increase your risk of bone loss and osteoporosis:
- glucocorticosteroids and adrenocorticotropic hormone used to treat conditions such as asthma and rheumatoid arthritis
- cancer medications containing hormones
- antiepileptic medications that treat seizures and neurological conditions
- protein pump inhibitors that treat reflux by lowering stomach acid
- selective serotonin reuptake inhibitors used to treat depression and anxiety
- thiazolidinediones used to treat type 2 diabetes
- lifestyle factors, including:
- alcohol consumption (more than 2 standard drinks a day)
- excessive caffeine consumption
Springs Medical’s Clinical Wellness Coordinator, Justine Stevenson, advises people at increased risk of osteoporosis to speak with their doctor about ways to maintain bone health and prevent falls. Your doctor may check your vitamin D and calcium levels and refer you for a DEXA scan to check your bone density. Your GP may also refer you to an exercise physiologist to help you with weight bearing exercises or resistance training to improve your bone strength. Medication is also an option for some people.
Activities such as tai chi, Qigong, Pilates and yoga are great for bones and promote better posture and balance which can reduce your risk of falls.
A DEXA scan is the most reliable way to diagnose osteoporosis by measuring your bone density, usually at the hip and spine. Justine says the test is a short, painless scan and may be covered by Medicare.
You may qualify for a Medicare rebate for a DEXA scan if you:
- have been diagnosed with osteoporosis
- have had one or more fractures due to osteoporosis
- are aged 70 or over
- have a chronic condition such as rheumatoid arthritis, coeliac disease or liver disease
- have taken glucocorticosteroids for a long time
Your doctor will be able to tell you if you are eligible for a Medicare rebate. You can still have a DEXA scan if you do not qualify for a rebate, but there will usually be an out-of-pocket fee.
Weight-bearing activities such as brisk walking, jogging, tennis, dancing or basketball encourages healthier bone density and improves your balance so your risk of falls is less. This type of exercise does not ‘treat’ established osteoporosis. Non-weight-bearing exercise such as swimming and cycling are excellent for fitness but do not promote bone growth.
Strength (resistance) training is also important for bone health. It can maintain or even improve bone mineral density. Justine says an exercise physiologist can recommend appropriate exercises and specific techniques. She says a weekly mix of strength training and weight-bearing exercise is ideal: ‘Aim for 30 to 40 minutes, four to six times a week. Exercise for bone growth needs to be regular and varied.’
Sources of Calcium
Dairy foods have the highest levels of calcium, but Justine says there are many other food sources such as sardines, spinach and almonds. If you’re unable to absorb enough calcium from your food, your doctor may suggest taking a calcium supplement.
‘I’ve seen people who’ve sought to lower their cholesterol by lowering their dairy intake, but you still need to have a good intake of calcium through other foods or supplements,’ Justine says.
Sources of vitamin D
Having enough vitamin D is important because it helps you absorb the calcium your diet. We get most of our vitamin D from the sun and there are recommendations about how much sun exposure is safe for sufficient vitamin D production. Vitamin D is also found in small quantities in fatty fish, such as salmon, herring and mackerel, liver and eggs. Most people are unlikely to obtain adequate amounts of vitamin D from food alone. Speak to your doctor if you need to restrict your sun exposure and are concerned you’re not getting enough vitamin D.
Justine is passionate about people taking action to support their bone health because she’s seen the devastating impact osteoporosis can have on people’s lives. ‘Now’s the time to get serious about protecting your bones, before it’s too late,’ she says.
Healthy Bones Australia: https://healthybonesaustralia.org.au/osteoporosis-you/diagnosis/
Better Health: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/osteoporosis