31 Oct 2011
By: AHMAD OSMAN
SOME 22,000 Singaporean women between the ages of 50 and 80 suffer from osteoporosis and that’s not counting the men who are also hit by the disease, according to Dr Manju Chandran, the director and consultant of Singapore General Hospital’s Osteoporosis and Bone Metabolism Unit and the Department of Endocrinology.
Osteoporosis reduces the density of bones, making them prone to fractures from falls and minor accidents. One in eight of Singaporean men above the age of 50 will have an osteoporotic fracture in their lifetime.
There are some 900 hip fractures among Singaporean men and women in Singapore every year. Compared to the 1960s, the number of male sufferers has jumped 1.5 times.
Although osteoporosis also affects younger men and women with low peak bone mass, it is not regarded as a serious disease by many people, says Dr Chandran.
“There is the misconception that it affects only the older folk and that men are not affected. There is also the lack of commitment to long-term medications,” she says. “Patients usually do not move on to long-term osteoporotic medications after the treatment to fix their fractures.”
The condition can lead to dire consequences. A hip fracture can reduce the quality of life for an elderly person who may be immobile and confined to bed. Research has shown that a quarter of elderly people die in the first year of a hip fracture, adds Dr Chandran.
“The chances of an elderly person having subsequent hip and other fractures increase exponentially after the first break. A fracture can be the first symptom of osteoporosis,” she says.
Dr Chandran also notes that the number of Singaporeans suffering from osteoporosis is likely to go up because of the rapidly ageing population.
“By 2050, half of the hip fractures around the world are expected to occur in Asian nations with rapidly ageing populations and lifestyle changes,” she says.
“Compared to Caucasians, Asians are generally lighter, have smaller bones and diets that are relatively low in calcium.”
A year-long campaign to raise global awareness on the prevention, diagnosis and treatment of the disease was launched recently in conjunction with the annual World Osteoporosis Day.
Women are at high risk of developing osteoporosis if they smoke or drink liquor heavily, have underweight issues, or lack physical exercise. Other signs include early menopause, a family history of the disease and a lack of calcium in their diet.
Post menopausal osteoporosis among women is due to a sharp drop of the bone-density building estrogen hormone.
Osteoporosis striking older men can be due to smoking, insufficient calcium and vitamin D, low testosterone, decline in bone and muscle strengthening activities, excessive alcohol and steroids.
Other causes of the disease affecting both genders include genetic pre-disposition, rheumatoid arthritis, excessive alcohol, thyroid hormones and steroids.
According to the International Osteoporosis Federation (IOF), brisk walking and other bone and muscle strengthening exercises will improve bone density, functional mobility and reduce falls for active older folk by 10 to 50 per cent.
It also recommends a minimum daily intake of 800 mg of calcium for a healthy adult and some 600 international units (IUs) of vitamin D from the age of one to 60. Those above 60 or at risk of fractures can take vitamin D supplements to boost daily consumption to 800 to 1,000 IUs.
To build strong bones, calcium and vitamin D are essential. They can be found in food sources such as milk, cheese, yoghurt, nuts and egg yolk. Fruits like figs and apricots as well as vegetables like bok choi and mushrooms are a nutritious source too. Eating fish with the bones intact such as sardines or choosing fatty fish such as salmon also gives a boost to one’s bone health.
What’s important as well is early diagnosis. There are effective and safe treatments that significantly reduce the risk of fracture, says IOF’s chief executive officer, Mrs Patrice McKenney.
Adequate calcium and vitamin D, combined with regular physical activity, especially weight-bearing and muscle strengthening exercises, can prevent or delay the onset of osteoporosis, says Dr Shyamala Thilagaratnam, the director of the Health Promotion Board’s Healthy Ageing Division.
“Take action now so that fractures due to osteoporosis don’t affect your health, happiness and independence as you age,” adds Mrs McKenney.
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