What is Senile Osteoporosis?

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Osteoporosis is a condition that affects a vast number of people around the globe, especially females. Osteoporosis causes loss of bone mass and bone mineral density. This leads to decreased bone strength, raising your fracture risk.

What is Senile Osteoporosis

Bones are living tissues that are constantly remodeled which means they are broken down continuously and replaced. This is termed bone turnover, and it determines bone metabolism.

In a person with osteoporosis, the new bone formation cannot keep up with the loss of bone tissue. This bone loss makes the person more susceptible to fractures.

In fact, in severe osteoporosis cases, the bones become so brittle that a slight fall or even a violent cough can cause fracture and debilitating pain.

Osteoporosis generally remains asymptomatic until the first signs of fragility fractures (following minor accidents or injuries), particularly in the case of vertebral fracture (mostly occurs to the lumbar spine). The insides of your bone have a honeycomb structure with many small spaces.

In a person with osteoporosis, these small spaces increase in size, resulting in reduced bone strength and enhanced bone fragility.

What Is Senile Osteoporosis?

Osteoporosis is generally classified as primary osteoporosis and secondary osteoporosis.

Primary Osteoporosis

Primary Osteoporosis of two types:

Type I Osteoporosis (Postmenopausal Osteoporosis):

As the name suggests, this generally develops after menopause. Estrogen affects osteoporosis– when estrogen levels drop precipitously, hormonal changes lead to bone loss, usually in the trabecular (spongy) bone inside the hard cortical bone.

Doctor explaining the xray film to his patient

Type II Osteoporosis (Senile Osteoporosis):

Senile osteoporosis is commonly found in people in their seventies and involves a thinning of both the trabecular (spongy) and cortical (hard) bone.

Senile osteoporosis can cause a notable decline in bone mass. This is due to an imbalance between bone resorption and bone formation. Bone resorption and bone formation are the essential components of bone remodeling.

Secondary Osteoporosis

It is defined as bone loss that results from specific, well-defined clinical disorders. Secondary osteoporosis can be reversed.


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What Are the Causes of Senile Osteoporosis?

Senile osteoporosis is an age-related disorder found mostly in people of seventy years of age, leading to the attenuation of both the cortical bone and trabecular bone.

The cancellous bone is affected badly because it is lighter and more porous than compact bone. Cancellous bone makes up about 20 percent of the human skeleton and provides structural support and flexibility. It provides more surface area for bone remodeling and is more metabolically active.

Senile osteoporosis is a geriatric disorder -an imbalance in bone remodeling that occurs as people age plays a major role in the development of senile osteoporosis. The maturing cortical and trabecular bones, in particular, cause a reduction in the bone density of the elderly.

Risk Factors for Senile Osteoporosis 

The risk factor for senile osteoporosis consists of age, race, lifestyle choices, genetic diseases, and certain medical treatments.

When it comes to impact, a postmenopausal woman is more likely to be affected by this disease when compared to adult men.

The risk factors may include the hormone levels in the body (sex hormones, thyroid hormones, or adrenal glands), dietary factors, and lifestyle choices (low calcium diet, eating disorders, or recent gastrointestinal surgery).

Drinking beer

A sedentary lifestyle, excessive alcohol consumption, and tobacco use can also elevate the risk of osteoporosis. Long-term usage of drugs and medicines like oral or injected corticosteroids may also cause osteoporosis.

These drugs directly interfere with the process of bone rebuilding and maintenance. Osteoporosis is sometimes related to medications such as antiepileptics, antacids, chemotherapy, and immunosuppressants.

Medical Conditions That Aggravate Osteoporosis:

The risk of osteoporosis is high among people suffering from medical conditions like Celiac disease and inflammatory bowel disease, kidney or liver disease, cancer, lupus, and rheumatoid arthritis.

Some studies reveal strong evidence that the development of osteoporosis is related to a deficiency of zinc in the body. Zinc deficiency plays a role in the pathogenesis of senile osteoporosis.

Zinc deficiency can lead to increased endogenous heparin in the body. This leads to low bone mass, making bones more fragile. These factors are known to enhance the pathogenetic process attached to senile osteoporosis as they elevate the action of the parathyroid hormone.

hand xray

Research reveals that bone marrow stromal cells differentiate into more adipocytes as age increases rather than going through osteoblast differentiation. (Osteoblasts are bone cells responsible for bone formation).

These bone marrow stromal cells undergo aging. Eventually, there is a significant reduction in bone formation, leading to senile osteoporosis

A low calcium diet and a decrease in the absorption of vitamin D also contribute to a diagnosis of type II osteoporosis. As people age, the collagen in the body deteriorates, leading to a reduction in bone health and mineral density.

This decrease in collagen and reduction in bone density might be a cause of osteoporosis. As bone mass density measures the density of minerals like calcium in bones, a low bone mass and bone mineral density are associated with enhanced bone fragility and the likely development of osteoporosis and fractures.

Reduction in collagen can also lead to heart disease, autoimmune diseases like rheumatoid arthritis, and reduced hair growth.


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What Are the Complications Caused by Senile Osteoporosis

Vertebral Fracture

Vertebral compression fracture (VCFs) is the fracture of the bones in the back. It can cause long-term complications, including curvature of the spine (kyphosis), intense back and joint pain. VCFs can also increase deficits in physical, psychological/social functioning.

Further complications include:

  • Reduced range of motion 
  • Collapsed lung or pneumonia
  • Compression of abdominal organs leading to decreased appetite and constipation
  • Deep venous thrombosis
  • Progressive muscle weakness
  • Increased risk of repeated vertebral fractures 

These are some of the consequences of VCFs. Advanced stages of senile osteoporosis can lead to death.

Colles’ Fracture 

Further complications include:

  • Persistent neuropathies of nerves in the arm
  • Radiocarpal or radio-ulnar arthrosis
  • Tendon ruptures
  • Associated injuries 
  • Stiffness in fingers
  • Shoulder-hand syndrome 

Hip Fracture

Osteoporosis can cause pain in the hips. In the advanced stages, there are chances of hip fracture and about half of the people who suffer from a hip fracture remain unable to fully regain their mobility.

hip fracture after falling on the ground

If a hip fracture keeps you immobile for a long time, bedsores and risk of urinary tract infections are normal.

Further complications include:

  • Blood clots in your legs or lungs
  • Pneumonia
  • Further loss of muscle mass, increasing your risk of falls and injury

Additionally, people who’ve had a hip fracture are at increased risk of weakened bones and further falls — which means a significantly higher risk of having another hip fracture.

Hip and vertebral fragility fractures are associated with significantly higher mortality rates. There is no proven solution to improving fracture survival in osteoporosis to date.

The independent role of fractures versus other factors, including functional status, comorbidities, capacity for independent living, etc., in increased mortality rates is uncertain.

Timely treatment of osteoporosis, with a diet plan for osteoporosis for patients who already suffered from a fracture, reduces morbidity and may translate into better chances of living well with osteoporosis.


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Prevention and Treatment of Senile Osteoporosis

It is important to evaluate the risks for poor bone health at all ages. Those in greatest need should receive a full assessment of bone health and fragility fracture risk

The best way to check bone health is a bone density scan called DEXA (Dual-energy x-ray absorptiometry). The Fracture Risk Assessment Tool (FRAX) is a tool that can give an estimate of the probability of a major osteoporotic fracture in the future.

DEXA Sxan for Osteoporosis diagnosis

This algorithm is designed for primary care. Along with age and genetics, bone mineral density is the next major determinant of fracture risk.

Individuals with a low trauma vertebral fracture or low bone mineral density for their age should get themselves checked to find out the underlying causes of osteoporosis. Secondary causes account for up to 40% of cases of osteoporosis in women and 60% in men.

The goal of osteoporosis management is to reduce the future risk of fracture. Lifestyle modification includes measures to reduce falls risk and bone loss such as exercise, adequate dietary calcium, and avoidance of smoking, and excessive alcohol consumption.

Good nutrition and regular exercise are key to osteoporosis prevention. The elderly at risk of osteoporosis should reduce alcohol consumption and smoking.

Now, osteoporosis in the elderly can give rise to a host of oral health issues. Regular dental visits are essential in fixing these dental concerns caused by weak bones.

Foods for Bone Strength

Consume a well-balanced diet containing high amounts of Vitamin D and calcium. Calcium-rich foods include milk, yogurt, cottage cheese, kale, broccoli, and sardines.

Supplements for osteoporosis can also be taken to prevent calcium deficiency. However, older people must consume Calcium and Vitamin D supplements with caution. The best exercises for strengthening bones are jogging, weight-bearing exercises, aerobics, dancing, and walking.

Treatment for Senile Osteoporosis

Many drugs can reduce senile osteoporosis from worsening. Alendronate and risedronate, consumed once a week provide a significant reduction in further bone degeneration. Denosumab is approved for postmenopausal osteoporosis in women.

Strontium ranelate also has been shown to reduce fracture risk significantly in postmenopausal women. Certain genetic recombination therapies involving mRNA expression and genetic enzymes have also been suggested to promote osteogenic differentiation.

When it comes to the management of osteoporosis in the elderly, findings reveal an acute loss of bone mineral density, followed by a more progressive decline in bone health. A significant increase in bone resorption leads to an initial fall in bone mineral density. With increasing age, there is also a significant reduction in bone formation.

New potential treatments, including therapeutic approaches to osteoporosis in elderly people focusing on the pathophysiology and possible reversal of the adipogenic shift in bone, must be popularised.