Dr Parthajit Das, director, Asian Institute of Immunology and Rheumatology

Osteoporosis is a health condition characterised by low bone mineral density (BMD) and significant microarchitectural deterioration of bone tissue, leading to increased bone fragility and fracture susceptibility. BMD decreases progressively with age, and hence the incidence of fragility fractures increases in an exponential manner as we grow older.

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According to World Health Organization (WHO) statistics, 30 per cent of postmenopausal women suffer from osteoporosis. Since osteoporosis is more common in women than in men, it is often thought of as a women’s disease. Worldwide, 12 per cent of men have osteoporosis. It has been reported that 61 million people in India have osteoporosis, with 20 per cent being men. The peak incidence of osteoporosis in India occurs 10–20 years earlier than in Western countries. At the age of 50, the lifetime risk of experiencing an osteoporosis-related fracture is about 20 per cent for a man, while it is close to 50 per cent for a woman. As compared with women, fragility fractures in men are associated with considerable morbidity and mortality. Osteoporosis-related fractures are the fourth leading cause of chronic burdensome disease, following ischemic heart disease, dementia and lung cancer. The financial burden, morbidity and mortality related to osteoporotic fractures are considerable and likely to increase in the future in this ageing population. Unfortunately, men are less likely than women to be evaluated for osteoporosis after a fracture. Moreover, men are also less likely to get osteoporosis treatment.

Osteoporosis can be diagnosed with the help of a DEXA scan and a bone density test. A bone density scan is an imaging test that measures the strength of your bones. It uses X-rays to measure how much calcium and other minerals are in your bones.

There are several factors that can increase the risk of developing osteoporosis, such as prolonged use of high-dose steroids or anti-epileptic medicines, eating disorders such as anorexia or bulimia, heavy smoking or drinking and other medical conditions, e.g., inflammatory conditions, hormone-related conditions and malabsorption problems. If you are at risk of developing osteoporosis, you should take steps to keep your bones healthy and strong. Regular exercise (aerobic and muscle-strengthening exercises), healthy eating (including foods rich in calcium and vitamin D), and making healthy lifestyle changes such as giving up smoking and reducing alcohol intake are strongly recommended to keep your bones strong. Dietary calcium can be found in dairy products such as milk, cheeses, and yoghurt; dark leafy greens (such as spinach, broccoli, and kale); and calcium-fortified foods and juices. If you are diagnosed with osteoporosis, there are steps you can take to reduce your chances of a fall, such as removing hazards from your home and having regular sight and hearing tests.

The aim of osteoporosis therapy is to reduce the increased fracture risk associated with osteoporosis-related bone fragility. Insights from basic bone biology and pathophysiology have resulted in the identification of several new therapeutic targets for the treatment of osteoporosis. Medical research has offered us several forms of anti-osteoporosis medicines suitable for your requirements, such as weekly oral tablets (alendronate, risedronate), monthly oral tablets (ibandronate), 3 monthly injections (ibandronate), 6 monthly injections (denosumab), or yearly injections (zoledronate). Please feel free to speak with your doctor to diagnose and treat osteoporosis at an early stage with appropriate medicines to avoid disastrous outcomes, e.g., wrist, hip, or vertebral fractures. The best way to prevent bone fractures is to catch osteoporosis before it can hurt you.