Osteoporosis is a silent disease because it may not show any symptoms, warns expert

“The intent is to disseminate awareness regarding the gravity and prevalence of bone health-related issues and their comprehensive management. In the next 20 years, everybody above 70 will get osteoporosis, with the risk factors in the Asia-Pacific region higher than in the Western world. Osteoporosis is a silent disease because it may not be present with symptoms, and it may not be evident until one or more bones break,” explains Prof Sanjay Bhadada, head, Department of Endocrinology, PGI.

Osteoporosis is the major cause of fractures in postmenopausal women and in older men.

In fact, one in three postmenopausal women and one in five men above 50 years are expected to sustain a low-trauma fracture in their lifetime. Fractures are associated with increased chances of dying. The Department of Endocrinology, PGI, has been working actively in the field of osteoporosis.

For the last one year, the department has been operating an Osteoporosis and Metabolic Bone Disease (OPMBD) Clinic every first Tuesday of the month, especially dedicated to the care of patients with osteoporosis and other bone diseases.

“For more than a year, the department has also been operating an online Osteoporosis Registry of India (ORI) where we have hitherto been able to assimilate the data of 130 patients with osteoporosis. Besides, we, along with other stalwarts within the fields of osteoporosis, have come forward with the many Indian guidelines for the management of osteoporosis in adults,” adds Prof Bhadada. So far, the department has data of 130 people with osteoporosis visiting the Endocrinology Clinic and most of the people are female (93%).

The mean age is 63 years and 20% of the people had sustained one or more fractures. Nearly one-fourth of the people had diabetes mellitus while 3% had celiac disease. 27% of the people with osteoporosis had sustained one or more falls in the last year,” says Prof Bhadada.

According to Prof Bhadada, it is imperative that women above 60 and men above the age of 65 get a screening for osteoporosis, and those below 50, who have low BMI, and are categorised as having a fragility factor must also opt for screening.

“People with diabetes, rheumatoid arthritis, those on steroids are also screened, with new machines, scans to screen, diagnose and detect the progress of osteoporosis and new markers to give us a chance for better treatment. While in 70 to 80 per cent of patients, the disease is silent, symptoms include back pain, bone pain, and vague abdominal pain. Long-term use of antacids causes risk,” says Prof Bhadada, who released a booklet entitled, ‘Osteoporosis-Karan and Nibaran’, that highlights the day-to-day aspects involved in the prevention and management of osteoporosis.

The doctors of the department emphasise that fall prevention is a major and indispensable component of long-term osteoporosis care, with the non-pharma

aspect of prevention and management extremely important. Vitamin D and Calcium are the building blocks of bones, with Vitamin D deficiency seen in 60 to 80 per cent of people, and 800 mg of calcium a day is required for bone health.

“Our lifestyle has ensured we have a longer life span, but the need is to have a good quality of life and so we need to focus on prevention and management.” This year, the International Osteoporosis Foundation (IOF) has proposed the propaganda of Step Up for Bone Health. IOF proposes that at any age, there are five steps to better bone health that will reduce the future risk of osteoporosis and fractures.