Osteoporosis is a disease of the skeletal system characterized by impaired remodelling of the bone substance and a pathological microarchitecture. This leads to reduced bone density and an increased risk of fractures. The disease often affects women aged 45 and over and men aged 55 and over, with women being disproportionately affected due to hormonal changes after the menopause.
Early detection can be achieved by Bone density measurements However, in women under 65 without risk factors, this has more disadvantages than advantages, as it can cause anxiety and lead to a lack of exercise.
For prevention and treatment, a balanced dietrich in protein, calcium and vitamin D and regular exercise are crucial. These measures help to bone density and prevent falls.
Treatment can be supported by various drugs, such as raloxifene, which has estrogen-like properties. It can reduce the risk of spinal fractures without the negative side effects of oestrogen.
There are two main types of osteoporosis:
1. primary osteoporosis: this type accounts for around 95 percent of all cases and occurs without the presence of other pre-existing conditions. It often affects menopausal women and older men.
2. secondary osteoporosis: This occurs in only 5 percent of cases and is a side effect of other diseases or results from taking certain medications, such as glucocorticoids.
Further subcategories can be identified within these types. Type 1 refers to postmenopausal osteoporosis, while type 2 is known as senile osteoporosis, which mainly affects people aged 70 and over.
All forms of osteoporosis lead to a decrease in bone density and increase the risk of fractures, particularly in the spine, femoral neck and wrist. The severity is often divided into categories, with osteopenia being considered the preliminary stage and manifest osteoporosis with fracture the more severe form.
Primary osteoporosis is the most common form of osteoporosis and accounts for around 90 percent of all cases, developing in the absence of other pre-existing conditions. This disease is divided into two types: Type 1, postmenopausal osteoporosis, particularly affects women after the menopause, while type 2, also known as senile osteoporosis, mainly affects people aged 70 and over.
The most common risk factors include advanced age, female gender, lack of exercise, being underweight and an unbalanced diet. dietespecially with regard to calcium and vitamin D. In Germany, the prevalence of primary osteoporosis is around 6%, with post-menopausal women, especially small-boned northern European women and smokers, being particularly affected.
A characteristic feature of primary osteoporosis is the decrease in bone mass, which increases the risk of bone deformities and fractures, particularly in the vertebrae, femoral neck and wrist.
Secondary osteoporosis is a form of osteoporosis that occurs as a side effect of other diseases and accounts for only about 5 percent of all cases. Various health disorders can lead to the development of this form of the disease. Hormonal imbalances, such as those that occur in Cushing's syndrome or hyperthyroidism, are common causes. Chronic kidney disease also contributes to the development of secondary osteoporosis.
In addition, certain types of cancer, particularly multiple myeloma, can weaken bone tissue and lead to osteoporosis. The long-term use of certain medications, such as corticosteroids, thyroid hormones and chemotherapeutic agents, can also be a significant risk factor. Finally, diseases such as coeliac disease and rheumatoid arthritis also promote the development of this bone disease. Treatment of the underlying disease is crucial for the management and prevention of secondary osteoporosis.
Idiopathic osteoporosis is a rare form of osteoporosis whose causes are unknown and which occurs without any identifiable risk factors. This disease can occur in women before the menopause, men under the age of 50 and in children and adolescents. Those affected usually have normal hormone and vitamin D levels and there are no clear causes for the weakening of the bones.
Despite its rarity, idiopathic osteoporosis is a serious condition that increases the risk of bone weakness and fractures. The disease is often asymptomatic, meaning that many sufferers are unaware of any symptoms until they suffer fractures. The diagnosis and management of this form of osteoporosis requires careful investigation to rule out other causes and find an appropriate treatment. It is important to seek medical advice promptly if osteoporosis is suspected in order to preserve long-term bone health.
Osteoporosis is a serious disease with many risk factors. A significant factor is old age, as the likelihood of bone loss increases with age, especially in post-menopausal women, who are particularly susceptible to postmenopausal osteoporosis.
The female sex itself is a significant risk factor. In addition, lack of exercise can increase the risk; regular physical activity is crucial for maintaining the bone density. Insufficient nutritionespecially a lack of calcium and vitamin Dalso contributes to the development of osteoporosis.
Last but not least, lifestyle factors such as excessive tobacco and alcohol consumption also play a role. These habits promote bone loss and increase the likelihood of osteoporotic fractures. Taking these risk factors into account is crucial for the prevention and early intervention of osteoporosis.
Osteoporosis usually develops after the age of 50 and becomes more common with increasing age. Women are particularly affected, usually after the menopause from around the age of 45, while men often develop the disease from the age of 55. In a survey, around 10% of men and 20% of women aged 70 reported having been diagnosed with osteoporosis. Primary osteoporosis, also known as senile osteoporosis, occurs mainly in older people aged 70 and over.
An important factor in the more frequent development of osteoporosis is the oestrogen deficiency caused by age and the menopause in women. This deficiency contributes to an increased risk of bone fractures and other complications. Therefore, it is important to educate younger people about the importance of bone care and appropriate preventative measures to reduce the risk of developing the disease later in life.
Osteoporosis is not just a disease that affects women; around 25 percent of cases also occur in men, and the trend is rising. Post-menopausal women in particular are at risk, with around 50 percent of them suffering an osteoporosis-related fracture in the course of their lives. In men over the age of 50, the figure is around 20 percent.
Primary osteoporosis is common in menopausal women and older men. In women, oestrogen deficiency plays a decisive role in the development of the disease. In men, a lack of male sex hormones can contribute to osteoporosis, particularly in connection with the age-related decline in oestrogen.
One of the prevention strategies in postmenopausal women is the use of estrogens, especially when other medications are not tolerated or contraindications exist. These gender-specific aspects emphasize the need for a gender-equitable approach in the prevention and treatment of osteoporosis.
Osteoporosis can occur in primary and secondary forms. Primary osteoporosis, which accounts for 95 percent of cases, develops without obvious pre-existing conditions. The most common risk factors include advanced age, female gender, lack of exercise, being underweight and insufficient diet with too little calcium and vitamin D.
Secondary osteoporosis, on the other hand, results from various diseases. Chronic kidney disease, hormonal disorders such as Cushing's syndrome or hyperthyroidism and some types of cancer, such as multiple myeloma, can lead to it. In addition, certain medications, including corticosteroids, progesterone and some chemotherapeutic agents, can cause secondary osteoporosis if taken over a long period of time.
Lifestyle factors such as excessive alcohol and cigarette consumption are also significant risk factors that can contribute to the development of osteoporosis. Early detection and treatment of the underlying causes are crucial for the prevention and management of this disease.
Osteoporosis is often asymptomatic in the early stages, so patients often only become aware of the disease when it is more advanced. Advanced symptoms include Bone painparticularly in the back, and fractures, which typically occur in the femoral neck, wrist and vertebral body. Another sign of advanced osteoporosis may be a loss of height of more than four centimeters within a year, indicating changes in posture or spine.
In addition, symptoms such as an unsteady gait and a characteristic body shape that includes a hollow back and an osteoporotic belly may occur. The disease also leads to a reduced bone densitywhich is characterized by bone density measurements can be detected. A reduced bone density is considered a risk factor for future fractures. Early detection and treatment is therefore the key to avoiding the serious consequences of osteoporosis.
Back pain is often an early warning sign of osteoporosis, especially in people over 50. It is important to pain seriously, as they can indicate a possible osteoporotic vertebral fracture. The pain can occur suddenly and is often described as intense and localized.
Typically, this pain worsens when standing or walking and is associated with tenderness to touch in the affected area. Even if the pain may subside after a week or so, it may persist for months or become chronic.
In addition, spinal compression caused by osteoporosis can lead to a curvature of the spine, which can also lead to muscle hyperextension and further pain and further pain. It is therefore advisable, in the case of persistent back pain medical advice, especially for the early diagnosis and treatment of osteoporosis.
Osteoporosis often leads to fractures known as spontaneous or fragility fractures. These fractures often occur without significant force. Affected individuals have a slower healing rate, which can lead to possible deformities such as spinal curvatures. The hip and spine are most commonly affected, but theoretically any bone in the body can be injured.
In 2017, around 765,000 cases of spontaneous fractures directly attributable to osteoporosis were documented in Germany. Typical fracture types in osteoporosis patients include femoral neck fractures and radius fractures, which often occur without severe falls. These increasing fractures pose a significant health risk and highlight the need for early detection and treatment of osteoporosis. Essential preventative measures include a balanced dietregular exercise and, if necessary, the intake of medication to maintain the bone density to strengthen bone density.
In addition to the symptoms already mentioned, such as a decrease in height and the "fir tree phenomenon", there are other signs of osteoporosis. One possible symptom is the presence of an osteoporotic belly, which describes a bulging lower abdomen. A hollow back is also frequently observed and can have a negative impact on posture.
In addition, many of those affected suffer from persistent back painwhich can occur without acute injury. This pain can be based on tense muscles or vertebral injuries.
Another important sign is an unsteady gait, which is caused by the increased susceptibility to fractures. These mobility problems can severely affect the balance of those affected and increase the risk of further injuries.
In summary, it is important to be aware of these symptoms as they can indicate osteoporosis and allow early action to be taken for prevention and treatment.
Osteoporosis is mainly diagnosed using imaging techniques, in particular X-rays and bone density measurements (DXA). These methods allow the determination of bone mineral density and the detection of changes in bone structure. X-rays can indicate osteoporosis in the case of several fractured vertebrae, but the diagnosis cannot be based solely on this method.
The bone density measurement uses low-dose X-rays to measure the mineral salt content in the bones, with the result given as a T-score. A comprehensive diagnosis also includes the exclusion of other diseases that could affect bone metabolism, as well as a thorough history of risk factors and previous fractures.
In addition, laboratory tests are helpful to rule out other underlying conditions, and in rare cases a bone biopsy may be required to confirm the diagnosis.
The bone density is mainly determined by Dual X-ray absorptiometry (DXA) which is considered the standard for diagnosing osteoporosis. The results are expressed as a T-score; a value of < −2,5 deutet auf Osteoporose hin, während Werte > -1 is considered normal. The bone density measurement however, is not part of the statutory health insurance benefits for the early detection of osteoporosis. Patients generally have to pay for the tests themselves, unless there is a specific suspicion of osteoporosis. In addition to DXA, radiological procedures such as X-rays and osteodensitometry are also used, which can detect changes such as lightening of the bone structure and narrowing of the cancellous bone flakes. Although quantitative computed tomography (QCT) enables precise measurement, it is rarely used in routine diagnostics due to the high radiation exposure. DXA therefore remains the preferred method for assessing the bone density and for monitoring the progression of osteoporosis.
Dual X-ray absorptiometry (DXA or DEXA) is the most widely used procedure for measuring the bone density and forms the basis for the WHO diagnostic definition of osteoporosis. In this method, weak X-rays are passed through the femoral neck or lumbar spine to determine the mineral salt content in the bones. DXA enables precise progression measurements and is particularly important in regions of the body where bone fractures can have serious consequences.
Another method is quantitative computed tomography (QCT), which is considered to be radiation-intensive and is used less frequently today. In the past, it was often used to determine the bone density in use. Quantitative ultrasound (QUS) is being evaluated for its effectiveness in assessing bone density. bone density is controversial as it has only been shown to be conclusive in a limited number of cases. These different imaging techniques offer different approaches to evaluating bone health.
The treatment of osteoporosis requires a comprehensive approach to strengthen bone health. Adequate intake of calcium (1,000-1,500 mg/d) and vitamin D is crucial to support bone mineralization. In the case of an osteoporotic vertebral fracture and a T-value of ≤ -2.0, drug therapy is also indicated, especially in the case of low bone densityhigh age or existing risk factors.
In addition to drug treatment, it is important to treat the underlying diseases and risk factors. Basic therapy also includes the promotion of physical activityabstaining from alcohol and nicotine and ensuring an adequate intake of calcium and vitamin D3.
Regular DXA scans should be performed in patients taking bisphosphonates or anabolic steroids to monitor the effectiveness of the therapy. This strategic combination of nutritiondiet, lifestyle and drug treatment can help to prevent the loss of bone density and reduce the risk of fractures.
Drug treatment for osteoporosis is usually recommended if fractures have already occurred or if the risk of fractures is greatly increased. Commonly used medications include bisphosphonates, raloxifene, teriparatide, oestrogens, fluorides and denosumab. These drugs are prescribed according to age and gender.
Hormone replacement therapies with oestrogen can reduce the risk of fractures, but are associated with risks for cardiovascular disease and breast cancer and should therefore only be used in exceptional cases. Long-term use of certain anticonvulsants, cytostatics and other substances can also increase the risk of osteoporosis.
Furthermore Calcium- and vitamin D supplements as an essential basic therapy for bone mineralization. Combination supplements with these nutrients are recommended to support optimal bone health. It is important to discuss the individualized therapy options with a medical specialist.
A balanced diet plays a decisive role in the treatment and prevention of osteoporosis. An adequate intake of protein is particularly important, calcium and vitamins. The German Society for Nutritional Medicine (DVO) recommends a daily calcium intake of 1000 mg and 800-1000 IU Vitamin D for osteoporosis patients to promote bone health. If the nutrition not sufficient Calcium supplementation in the form of tablets can be useful.
In addition, international guidelines recommend taking vitamin D together with calcium. However, certain metabolites such as 1-alpha or 1,25-dihydroxy vitamin D should be avoided. It is also important to avoid the consumption of alcohol and tobacco, as these habits have a negative impact on bone health and can increase the risk of osteoporosis. A targeted supply of nutrients is therefore an essential part of osteoporosis prevention and treatment.
Regular physical activity plays a crucial role in maintaining muscle tone and improving bone stability. Targeted exercise and sport stimulates the bone metabolism, which helps to maintain or increase bone strength. bone density density. Training balance and coordination is particularly important, as this can significantly reduce the risk of falls and associated bone fractures.
For people with osteoporosis, the Rheumaliga offers special exercise programs such as Osteogym, which are specifically tailored to their needs and promote mobility. These programs not only help to strengthen the muscles, but also support general mobility. fitness.
Preventing falls is another important aspect that is promoted by physical activity and an awareness of personal fall risks. An active lifestyle therefore not only contributes to physical health, but is also crucial for avoiding dangerous injuries.
The prevention of osteoporosis plays a crucial role, as maintaining the bone density is easier than treating bone mass that has already been lost. A balanced dietthat provides sufficient calcium and vitamin D is essential. For older people Strength and balance exercises are particularly important to improve muscle strength and minimize the risk of falling.
It is also beneficial to control risk factors such as smoking and excessive alcohol consumption, as these increase the risk of osteoporosis. In addition, people should be made aware of their individual risk of falling. Eliminating tripping hazards in the home is an important measure to prevent falls and potential fractures. These preventive measures can reduce the risk of osteoporosis and maintain quality of life in old age.
A balanced diet is crucial for the prevention and treatment of osteoporosis. Foods that are rich in protein, Calcium and vitamin D should be integrated into everyday life to support bone health. In addition, regular physical activity plays an important role. It strengthens the muscles and reduces the risk of falls, which can lead to bone fractures.
Preventing falls is very important for people with osteoporosis. It is advisable to remove tripping hazards in the home and improve lighting to create a safe environment. Older people should be aware of their physical and mental deficits and take active measures to strengthen themselves through Strength and rhythmic training and rhythm training.
It is also important to consciously assess your own risk of falling. By identifying and minimizing potential risks, it is possible to increase safety in everyday life and reduce the overall risk of fractures. A combination of healthy diet, exercise and fall prevention thus form the foundation for a better life with osteoporosis.
Source: istockphoto PeopleImages
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