Symptoms / Risk Factors
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| Three generations of women in a Korean village. The elderly women have 'kyphosis' (or hunched back) which is a sign of vertebral fractures caused by osteoporosis. A family history of osteoporosis is an important risk factor for the disease. |
Because bone loss is gradual and painless, there are usually no symptoms to indicate that a person is developing osteoporosis. This is one reason why osteoporosis is often referred to as the "silent epidemic".
Most often the first sign of osteoporosis is a fracture. In some cases, but not all, a stooped back (‘dowager’s hump’) and loss in height may be the only visible signs that a person has osteoporosis and may have already suffered spinal fractures.
Since the disease does not have obvious symptoms, doctors may recommend diagnostic testing depending on a person’s age and whether other fixed or modifiable risk factors can be identified.
Recognizing your risk for osteoporosis
Risk factors for osteoporosis fall into two main categories, modifiable and fixed (see below)
Although ‘fixed’ factors (which include age, gender, and family history) largely determine whether a person is at heightened risk of osteoporosis, ‘modifiable’ factors (‘lifestyle’) play a key role as well.
‘Modifiable’ factors, like good nutrition and exercise, help build bone during youth, and help to slow down bone loss in adults and the elderly. This means that everyone can take positive steps to strengthen their bones and reduce their risk of osteoporosis throughout life.
Bone mineral density (BMD)
Because minerals contribute to bone’s strength, low bone mineral density is one of the most important indicators that a person is at risk of a fracture. A person’s BMD is determined by both ‘fixed’ and ‘modifiable’ factors. BMD significantly decreases with age, but if it falls below a given threshold (see diagnosis) this indicates osteoporosis. Measuring BMD by dual energy X-ray absorptiometry (DXA) is presently the only reliable diagnostic test for osteoporosis. People, especially the elderly, who have many modifiable or fixed risk factors, should consult with their doctor about having a BMD scan. The BMD results are an important basis from which to discuss potential changes to lifestyles and possible treatments.
Fixed Risks
Although fixed risk factors cannot be changed, people need to be aware of them so that they can take steps to reduce bone mineral loss. Fixed risk factors also include what is termed ‘secondary risk factors’ – these include disorders that weaken bone or disorders and/or medications that affect mobility and balance (i.e. heightened risk of fracture due to falling).
Fixed risk factors include:
• Age
• Female gender
• Family history
• Previous fracture
• Race/ethnicity
• Menopause/hysterectomy
• Long term glucocorticoid therapy
• Rheumatoid arthritis
• Primary/secondary hypogonadism in men
Click here to see more detailed information about fixed risk factors including secondary risk factors
Modifiable Risks
Most modifiable risk factors directly impact bone biology and result in a decrease in bone mineral density (BMD), but some of them also increase the risk of fracture independently of their effect on bone itself. These include:
• Alcohol
• Smoking
• Low body mass index
• Poor nutrition
• Vitamin D deficiency
• Eating disorders
• Insufficient exercise
• Low dietary calcium intake
• Frequent falls
Click here to see more detailed information about modifiable risk factors
Individuals can take action to reduce these ‘modifiable’ risks and, although there is no way to control ‘fixed’ risks, there are strategies that can lessen their effect – once the risk is appreciated.
Find out whether you are at risk: Take the new IOF One Minute Osteoporosis Risk Test
