Early diagnosis is essential to effectively managing and treating osteoporosis, according to a senior physician at leading Abu Dhabi specialty hospital, Healthpoint, with the disease showing no visible symptoms until the patient suffers a painful and debilitating bone fracture.
Dr. Gianina-Elena Statache, a Rheumatology Specialist at Healthpoint, part of Mubadala’s integrated healthcare network, says around one in three women, and one in five men, over the age of 50 will suffer a fracture due to osteoporosis. The common condition gradually weakens bones over many years, making them fragile and more likely to break.
“Osteoporosis can be extremely painful and is a significant cause of disability among older people, yet many patients will have no idea they have the condition until it is already very well advanced,” explains Dr. Statache. “This is because the loss of bone mass does not cause any pain until a fracture occurs, showing the bone is already significantly weakened. Hence it is absolutely important to diagnose people as soon as possible.”
As an integrated, multi-disciplinary hospital, Healthpoint provides complete care to osteoporosis patients. For the past year, the hospital has operated a Fracture Liaison Service to identify patients admitted to the hospital with a fracture, and offering to assess them for osteoporosis. Where the disease is diagnosed, physicians can then follow up with appropriate treatment.
So far, the service has screened more than 100 patients, through an examination of the patient history, clinical examination, and procedures such as dual-energy X-ray absorptiometry (DEXA) and blood testing. Of those 100, more than 40 have been diagnosed with osteoporosis and fragility fractures.
This helps catch the disease while bones still have most of their strength when it still requires a more serious accident to cause the injury. With more advanced cases, even a minor fall, or in some instances a cough or sneeze, can cause a fracture. Spinal deformity, height loss, and severe back pain are among the longer-term effects of osteoporosis. Patients can find themselves confined to bed for long periods, be unable to walk, and lose much of their independence.
Yet there are some simple measures people can take to reduce the risk or severity of the disease in later life. Dietary supplements such as vitamin D and calcium, at doses instructed by a physician, are essential in osteoporosis – calcium to help rebuild bone, and vitamin D to help the body process the calcium – and a diet rich in these nutrients is important. Exposure to sunlight can also help replenish vitamin D and contributes to bone health.
Other preventative measures can include regular exercise. Even 30 minutes of walking every day can significantly increase the bone mass density (BMD) and is a very important step in managing the condition. Tobacco smoking and alcohol consumption are both linked to increased risk, so these should be avoided, as is being underweight, which reduces BMD. Eating disorders frequently leave bones more fragile in later life. Osteoporosis can also be made worse by other illnesses, such as inflammatory or hormone-related conditions, and by some medications. For women, the disease often becomes apparent after menopause.
“Osteoporosis is usually age-related, but it is not an inevitable consequence of getting older. In many respects, it is a lifestyle disease, and we can prevent the condition – or at least limit how bad it gets – by making lifestyle changes,” said Dr. Statache. “The important thing is to make these changes early, while our bones are still healthy, rather waiting until we see a problem and then trying to repair the damage that has already been done.”