Osteoporosis

 

Osteoporosis is a condition that causes fragility of the skeleton leading to fractures with minimal trauma (breaking a bone). To tell if someone has osteoporosis and what their fracture risk is, then the following are generally needed: a specialist consultation, a Bone Density Scan called a DXA (or 'DEXA') scan, some blood tests, and in an older person, a falls risk assessment. There are lots of drug therapies that have been shown to reduce fracture risk and treat osteoporosis successfully. Generally, tablet treatments have shown to reduce the risk of fracture by about 30-40% (e.g. alendronic acid), and the injection treatments reduce the chance of fracture by about 60-70% (e.g. zoledronate). If you are over 50 years old or (for women) if you have gone through your menopause and you have had a broken bone, then its advisable you have an assessment for osteoporosis.
 

Osteoporosis and fracture prevention – specific assessments

There is a lot of published guidance on how to assess people for osteoporosis and fracture risk, for example from the National Osteoporosis Society (link: www.nos.org.uk/page.aspx?pid=234) and NICE in The UK (link: www.nice.org.uk/cg146). A quantitative fracture risk assessment can be made using the online FRAX tool (www.shef.ac.uk/FRAX) and also see these PDFs:

Links and Resources:

PDF - Paper on Fracture Liaison Services (UK)

PDF - Glucocorticoid (steroid) Induced Osteoporosis

The chance of breaking a bone for an elderly person is importantly dependent, not only on the fragility of the skeleton, but on the risk of falling. There are a number of important things to look for and address with regard to 'falls risk'. See: https://www.nice.org.uk/guidance/cg161

and

PDF - Falls: the assessment and prevention of falls in older people

Osteoporosis treatments: The commonest treatments used to treat or prevent osteoporosis are called Bisphosphonates (Alendronic acid, Risedronate, Ibandronic acid, Zolderonic acid). Their effect is optimised if the person taking them does not have vitamin-D deficiency or calcium lack.

PDF - Patient information sheet on Zoledronate (Aclasta)

PDF - Patient information sheet on Denosumab (Prolia)

PDF - Patient information sheet on Forsteo (PTH injections)

A DXA scan is a quick, safe and simple scan that estimated the density of your bones. It is a completely open scanner without requiring undressing! See button below: