By Kaylee Schukei, Medical Assistant
As my patients age, they tell me that they feel as young as ever on the inside, but their bodies are declining and they want to know how they can stay as healthy as possible. Especially for women, an important factor to consider is bone density. During menopause, which usually occurs between the ages of 45 and 55, estrogen levels in women drop dramatically, leading to a decrease in bone mass, which can increase the risk of bone fractures (broken bones). Men also lose bone density as they age, but this usually happens at a slower rate and later in life than most women.
Inside, the bones have a honeycomb structure. Strong and dense bones have tiny holes while weak bones are more porous. Bones are made up of living tissue that the body continually replaces; this is called “remodeling”. As we age, our ability to replace bone minerals decreases and our bones become weaker and more brittle.
Having low bone mineral density is divided into two stages – osteopenia (the milder form) and osteoporosis (the more severe progression). Osteoporosis means “porous bone” and indicates that the body is not able to produce enough material to maintain bone strength, which can lead to a fractured or collapsed vertebra, bones breaking more easily than expected and / or or a hunched posture.
It’s never fun to break a bone, but for older adults it can be the triggering event that triggers a decline from which they can’t recover. Breaking a hip often requires a stay in hospital and then rehabilitation, which may involve a stay in a nursing home. Because of the fracture, the patients cannot take care of themselves and they cannot exercise to maintain their strength; they are caught in a reinforcing loop of decline.
The good news is that there are ways to slow the effects of the aging process and bone loss, starting with exercise. Thirty minutes of exercise a day, like a brisk walk, can have huge benefits. Adding some resistance training is even better, using bands or light weights for strength.
Getting enough calcium and vitamin D is also helpful. A balanced diet with calcium-rich foods is a good start. You can also take supplements to make sure you get at least 1000 mg of calcium per day. Although the sun is a wonderful source of vitamin D, you will need to balance the risks of skin cancer with the benefits of vitamin D. Consider exposing your skin to 10 minutes of sunlight daily and speak with your doctor about supplements of vitamin D., too.
If you are a smoker, one of the best things you can do is quit. Bones are made up of four types of cells:
Osteoblast: Building new bone tissue
Osteoclast: Absorbs and eliminates unwanted tissue
Osteocyte: Maintains bone as living tissue
Hematopoietic: Produces red blood cells, white blood cells, and platelets
During the process of bone remodeling, osteoblasts create new bone tissue, while osteoclasts remove old or unwanted bone tissue. Smoking accelerates bone loss by disrupting the bone remodeling process, leading to weak and brittle bones.
There aren’t many warning signs of osteoporosis and many people aren’t aware of how fragile their bones are until they fall and are forced to deal with a fracture. This is why it is important to get tested early. Healthy women should start getting screened at age 65 with a DEXA scan, which is a type of X-ray that allows us to determine bone density to assess the risk of osteoporosis.
Reduce the risk of falls
In addition to taking care of your body to reduce the risk of osteoporosis, you can also adjust your environment. Eliminate tripping hazards such as rugs and cords. Install sturdy handrails in showers and stairs. Consider ways to remedy slippery surfaces, make stairs more visible, and include good lighting throughout the house.
If you have questions about your bone health or how to stay strong as you age, ask your doctor. We are here to help.
Kaylee Schukei, PA, is a primary care provider at MCHC Health Centers, a community-based and patient-directed organization serving Mendocino and Lake Counties, providing comprehensive primary health care services as well as support services. such as education and translation that promote access to health care. Learn more at mchcinc.org.