According to the statistics of the China Disease Surveillance System, falls are the leading cause of death due to injuries among the elderly over 65 years old in my country. Elderly people are prone to fractures after falling, which is directly related to osteoporosis. The bedridden caused by fractures and a series of complications are a great blow to the human body. Regarding the diagnosis and treatment of osteoporosis, Xia Weibo, director of the Endocrinology Department of Peking Union Medical College Hospital, Li Mei, deputy director, and Cui Lijia, a resident physician, gave detailed answers.
Q: At what age does osteoporosis usually occur? Why does it happen?
Answer: According to the latest national osteoporosis epidemiological survey results, the prevalence of osteoporosis in men and women over the age of 40 is 5.0% and 20.6%, respectively. After menopause in women, the level of estrogen drops rapidly, and the inhibitory effect on osteoclasts is weakened, resulting in enhanced bone resorption and accelerated bone loss. Men will also increase bone loss due to lack of testosterone in the blood. In addition, lack of nutrition, poor lifestyle, disease affecting bone metabolism or taking related drugs will also accelerate bone loss and cause osteoporosis.
Q: What are the common symptoms of osteoporosis and how are they diagnosed?
Answer: Osteoporosis is known as a “silent epidemic” that may have no obvious symptoms at first. As the disease progresses, patients will experience low back pain or generalized bone pain, short height or hunchback, and fractures when subjected to mild external force.
The current diagnosis of osteoporosis is based on dual energy X-ray measurements of the spine, proximal femur, or distal radius. Osteoporosis is basically diagnosed if the following conditions occur: first, fragility fracture of the hip or vertebral body; second, according to the results of BMD measurement, compared with the mean bone mineral density of young people of the same sex, the T value is ≤-2.5; Densitometric T-scores ranged from -1.0 to -2.5, ie, decreased bone mass, with concomitant fragility fractures of the proximal humerus, pelvis, or distal forearm. Severe osteoporosis was diagnosed if the T value met the diagnostic criteria for osteoporosis and was accompanied by a history of one or more fragility fractures.
Q: After being diagnosed with osteoporosis, how should it be treated?
Answer: The first is to adjust your lifestyle. Expose as much of your skin to the sun as possible, especially between 11 a.m. and 3 p.m., which can promote vitamin D synthesis; eat a balanced diet with foods rich in calcium and moderate amounts of protein; exercise more , brisk walking, jogging, tai chi, yoga can be, be careful not to fall.
The second is to adhere to the basic drug treatment. For patients over 50 years old, it is recommended to add drugs to supplement 1000mg of elemental calcium every day, and at the same time pay attention to vitamin D supplementation, and can consume 800 to 1200IU of vitamin D per day.
Finally, use strong and effective anti-osteoporosis drugs. Currently effective anti-osteoporosis drugs include drugs that inhibit bone resorption or promote bone formation, which can increase bone density and reduce the risk of fractures. Before treatment, you must go to the hospital to evaluate the indications and contraindications of the drug, whether there is any correctable disease or incentive, and choose the drug scientifically and reasonably according to the doctor’s evaluation of the condition. After the drug treatment, it is necessary to adhere to the treatment and regularly evaluate the efficacy of the drug.