Question

Ms. B is a 75-year-old woman who has been living alone for the last 15 years. Following a fall and a broken pelvis a year ago, and a broken wrist about 6 months ago, she has been inactive and depressed. She has not been eating in a healthy fashion and gets very little exercise. For the past few months, she also has been developing a hunchback posture, along with a shuffling gait and difficulty breathing when she walks more than a few feet. Lab tests conducted recently revealed a decrease in her bone mass and density, possibly contributing to the two fractures she suffered in the past year.

1. Relate the history and signs and symptoms to the onset and course of osteoporosis. (See Osteoporosis.)

2. Discuss the several risk factors associated with osteoporosis. Which appear to be present in this case? (See Osteoporosis.)

3. Discuss recommendations to reduce the risk and progression of osteoporosis associated with aging. When should these recommendations be implemented? Why? (See Osteoporosis.)

Answer 1

1) characteristics of osteoporosis include reduction of bone density and a change in bone structure, both of which increase susceptibility to fracture as Ms B is suffering

-An average 75 year old women has lost 25% of her cortical bone and 40% of her trabecular bone, and an elderly absorba dietary calcium less efficiently and excrete it more readily through kidneys.

- with osteoporosis bones become progressively porous, brittle, and fragile, gradual collapse of a vertebra is observed as progressive kyphosis(hunch back)

- Postmenopausal women lose height from vertibral collapse, posture change result in relaxation of abdominal muscles and protruding abdomen, this deformity may produce pulmonary inefficiency(Difficult breathing like Ms B)

2) Risk factors for osteoporosis in Ms B are

-Women

- Increased age

- Estrogen deficiency or menopause

Other lifestyle risk factors include diet low in calcium and vitamin D, lack of sun exposure.

3) Recommendation to reduce the risk of osteoporosis

- Increase dietary calcium and vitamin D intake

- smoking cessation

- Alcohol and caffeine consumption in moderation( As these reduces osteogenesis in bone remodeling)

- Regular weight bearing exercise regimen( as bone need stress for bone maintenance)

- outdoor activity

These should be implemented early in life as upto 90% of peak adult bone mass is achieved between the ages of 18 and 20 years in females and males respectively.Failure to develop optimal peak bone mass during childhood, adolescence an young adulthood contribute to the development of osteoporosis.