Osteoporosis is a chronic metabolic bone disease characterized by decreased bone mass and deterioration of bone tissue, leading to increased bone fragility and susceptibility to fractures, particularly of the hip, spine, and wrist.
Causes / Risk Factors
Non-modifiable:
👉Age (especially >50 years)
👉Female gender👉Postmenopausal status
👉Family history of osteoporosis
👉Ethnicity (higher risk in Caucasians and Asians)
Modifiable:
👉Low calcium and vitamin D intake
👉Sedentary lifestyle
👉Smoking and excessive alcohol consumption
👉Low body weight or eating disorders
👉Certain medications (e.g., corticosteroids, anticonvulsants)
👉Chronic diseases (e.g., rheumatoid arthritis, hyperthyroidism)
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Symptoms
Osteoporosis is often called the “silent disease” because it typically has no symptoms until a fracture occurs.
👉Back pain (due to vertebral fractures)
👉Loss of height over time
👉Stooped posture (kyphosis)
👉Fragility fractures with minor trauma
👉Decreased mobility
Diagnosis
Bone Mineral Density (BMD) Test:
👉DEXA (Dual-energy X-ray Absorptiometry) scan is the gold standard.
👉T-score of -2.5 or lower indicates osteoporosis.
Laboratory Tests:
👉Serum calcium, phosphate, vitamin D, thyroid function, parathyroid hormone
👉Markers of bone turnover
X-rays:
👉To detect existing fractures
Treatment
Pharmacological:
👉Calcium and Vitamin D supplementation
👉Bisphosphonates (e.g., alendronate, risedronate)
👉Selective Estrogen Receptor Modulators (SERMs)
👉Hormone Replacement Therapy (HRT)
👉Monoclonal antibodies (e.g., denosumab)👉Anabolic agents (e.g., teriparatide)
Non-Pharmacological:
👉Weight-bearing and resistance exercises
👉Fall prevention strategies
👉Lifestyle modifications: quit smoking, reduce alcohol
👉Pain management and mobility aids if needed
Complications
👉Fragility fractures (hip, spine, wrist)
👉Chronic pain
👉Reduced mobility and independence
👉Postural deformities
👉Increased risk of further fractures
👉Depression and social isolation
👉Increased morbidity and mortality (especially after hip fracture)
Prevention
👉Adequate intake of calcium and vitamin D (diet and supplements)
👉Regular physical activity (walking, light weight training)
👉Avoid smoking and excessive alcohol
👉Regular BMD screening in at-risk populations
👉Educate patients on fall prevention
👉Maintain a healthy weight
Nursing Diagnosis
1. Risk for Injury related to decreased bone density and potential falls.
2. Acute or Chronic Pain related to fractures or vertebral compression.
3. Impaired Physical Mobility related to pain and skeletal deformities.
4. Disturbed Body Image related to postural changes (kyphosis) and height loss.
5. Knowledge Deficit regarding disease process, prevention, and self-care.
6. Risk for Impaired Skin Integrity due to immobility or use of assistive devices.
7. Risk for Falls related to altered gait, poor balance, or vision changes.
