Bone and calcium disorders include osteoporosis, Paget's disease, osteomalacia, rickets, and hyper- and hypoparathyroidism.
Osteoporosis is fast becoming an epidemic, due to the ageing population in Australia and worldwide. It is characterised by thinning of the bones, resulting in decreased bone density. This leads to an increased risk of fracture. It is a silent disease, remaining asymptomatic until a fracture develops. In Australia, it is estimated that 1 in 2 women and 1 in 3 men over 60 years of age will eventually develop an osteoporotic fracture.
Preventing osteoporotic fractures requires a combined approach to therapy:
• Regular exercise to improve muscle strength and balance
• Reducing the risk of falls and subsequent fractures
• Adequate vitamin D through supplements or sun exposure
• Adequate nutrition with attention to calcium and protein intake, with calcium supplements as required
• Treating various illnesses that cause or worsen osteoporosis
• Medications to improve or maintain bone density.
Patients who are at risk are adivsed to have a DXA bone density scan. Risk factors include:
• Patients 70 years old and over
• Previous fragility fracture
• Rheumatoid arthritis
• Chronic liver or kidney disease
• Malabsorption problems (such as coeliac disease)
• Thyroid overactivity
• Prolonged corticosteroid therapy
• Premature menopause (females) or low testosterone levels (males)