Osteopenia among the elderly is a common bone disorder characterized by lower bone mineral density than normal. In osteopenia, the bone mineral density is not low enough to be diagnosed as osteoporosis. To prevent osteopenia from causing any complications like osteoporosis, taking care of your diet, exercising regularly, and getting your bone mineral density tested are some safe options.

Your bone mineral density is at its peak when you’re in your 30s. By the time you’re 50 years old, your bones start losing their density. Your body keeps breaking down and reabsorbing bone cells throughout life, but many specialized cells keep building new bones using calcium. Therefore, your bones maintain their strength and mass.

When you age, the rate at which your body reabsorbs the bone cells increases more than the rate at which it replaces the cells, leading to decreased bone mineral density. If your bones are not naturally dense, you may get osteopenia.

 

 

What Is Osteopenia?

Osteopenia is a bone condition described as a decrease in bone mineral density (BMD) than normal (not as decreased to be called osteoporosis), leading to weaker bones and an increased risk of bone fractures. Simply put, osteopenia is the midpoint between healthy bones and osteoporosis.

Bone mineral density (BMD) measures how much calcium and other minerals are in your bones. As you age, your bones become weaker due to the loss of minerals, mainly calcium. If you have osteopenia, your bones have a lower BMD than normal.

 

 

Osteopenia vs. Osteoporosis:

Osteopenia and osteoporosis are different bone conditions related to bone mineral density. Osteopenia can be described as a lower bone density than normal, but not low enough to be diagnosed as osteoporosis. Bone mineral density (BMD) ranging between -1 and -2.5 is known as osteopenia and a bone density score lower than -2.5 is medically diagnosed as osteoporosis.

Osteoporosis is considered more severe than osteopenia with more risk of bone weakening and fractures. A decrease in bone density causes the honeycomb-like structure in the bones to become more porous, resulting in the loss of bone strength. Fragile and weak bones due to osteoporosis put you at higher risk of breaks and fractures.

 

 

What Are The Complications Of Osteopenia?

Since aged people with osteopenia are more likely to have osteoporosis, it is important to manage the condition before it gets worse. Preventing osteopenia from progressing to osteoporosis requires lifestyle modifications, healthy diet plans, and exercising regularly.

If not treated early, osteopenia can lead to osteoporosis that leads to many complications, including stooped fractures, bone fractures, severe pain, and inability to walk or engage in daily life activities. When fractures occur, they take more time to heal with age.

 

 

Causes Of Osteopenia In the Elderly:

Aging is one of the most frequent causes of the development of osteopenia in the elderly. When a person enters their 50s, their body breaks down bone cells at a faster rate than it builds new bone cells. This leads to the loss of bone density over time.

Women after women start losing bone density quickly due to low levels of estrogen. Also, women are more at risk of osteopenia than men. It is because women absorb less calcium and have lower bone mass than men.

The following are some preventable causes of osteopenia in older adults:

• Lack of physical activity

• Regular soda consumption

• Certain medications, including phenytoin, prednisolone, and prednisone have also been linked to osteopenia.

• An eating disorder

• Vitamin D and calcium deficiency

• Excessive alcohol consumption

Risk Factors For Osteopenia:

The following are some risk factors contributing to osteopenia:

Age: Both men and women start losing half of their bone density every year once they’re over 50.

Race: The risk of developing osteopenia increases in people of Asian descent and Caucasians.

Gender: Postmenopausal women are more likely to be affected by osteopenia due to decreased levels of estrogen.

Chronic Inflammation: Certain inflammatory diseases, such as Crohn’s disease and rheumatoid arthritis also at a higher risk of developing osteopenia.

Genetics: Older people with a family history of osteoporosis and early bone loss are at higher risk of osteopenia.

 

 

Symptoms Of Osteopenia:

Usually, osteopenia comes with no symptoms and is usually diagnosed unless a person has:

• Bone fracture

• Weakness in the bone

• A localized pain in the affected bone

• Undergone a bone density test

Since osteopenia has no apparent symptoms, the condition may be present for many years without being diagnosed. Bone fractures that occur due to osteopenia, such as vertebral fractures or hip fractures, happen to be very painful.

Diagnosis Of Osteopenia:

Patients with osteopenia are hard to be diagnosed the condition because there are no symptoms indicative of osteopenia. According to the National Osteoporosis Foundation, you’re a candidate for getting your BMD tested if you are:

• Postmenopausal

• A woman aged over 65 years.

• A man over 50 years with one or more risk factors.

• Have broken a bone after age 50.

• A postmenopausal woman with a high chance of breaking bones.

• Have had surgery to remove ovaries

The most common diagnostic procedure for testing BMD is:

Dual-Energy X-ray Absorptiometry (DEXA) Test:

DEXA test is used to measure bone mineral density in the total body, hip, finger, heel, wrist and spine. The test using a lower radiation x-ray beam to measure the BMD. The results of DEXA will represent your T-score, which will diagnose whether you have osteopenia or not.

T-Score	Diagnosis
+1.0 to -1.0	No diagnosis of osteopenia (normal BMD)
-1-0 to -2.5	Osteopenia diagnosed (low BMD)
-2.5 or more	Osteoporosis diagnosed

 

Other diagnostic approaches also used for osteopenia diagnosis include:

• Quantitative ultrasound densitometry (QUS)

• Quantitative computed tomography (QCT)

• Peripheral quantitative computed tomography (pQCT)

• Peripheral dual-energy x-ray absorptiometry (DEXA)

 

 

Treatment For Osteopenia:

Proper treatment is important for patients with osteopenia to prevent it from developing into osteoporosis. The early treatment intervention involves lifestyle modification and healthy dietary habits. Your doctor won’t prescribe any medication because osteopenia has a smaller risk of bone fractures. Medications are prescribed when a patient’s BMD level is close to that of osteoporosis.

 

1. Osteopenia Diet:

Eating foods rich in vitamin D and calcium can help people with osteopenia strengthen their bones. Osteopenia can be prevented when your dietary intake of vitamin D and calcium is sufficient. Foods rich in calcium include:

• Wild freshwater salmon

• Spinach

• Broccoli

• Dried beans

• Dairy products, including yogurt, milk, and cheese.

• Sardines

Rich food sources of vitamin D include:

• Fortified cereals

• Orange juice

• Mackerel

• Oily or fatty fish

• Beef liver

Calcium and vitamin D supplements may be prescribed by your doctor if dietary intake is not enough. The daily recommendations on vitamin D and calcium intake include:

1. Calcium:

• 1000 mg daily for young men and women.

• 1200 mg of calcium, including calcium supplements and diet, for women of over 50 years entering menopause and men of 71 years old.

 

       b. Vitamin D:

• 400 IU of vitamin D for infants of 6 months old.

• 600 IU of vitamin D for children, men, and women.

• 800 IU of vitamin D for men and women aged over 71 years.

 

       2. Osteopenia Exercises:

If you are a patient with osteopenia, you can strengthen your bones by jumping, running, or walking for 30 minutes a day. Exercising regularly not only treats osteopenia but also prevents its progression to osteoporosis. You can improve your bone mass by exercising without any further bone loss.

Some exercises for osteopenia patients include:

• Using weight machines

• Weight lifting

• Body weight exercises, like squats and push-ups.

Yoga, Tai chi, and weight-bearing exercises, including walking, stair climbing, and dancing help build bone mass and reduce the chances of falling.

 

 

     3. Medications:

Besides over-the-counter vitamin D and calcium supplements, your doctor may also prescribe you medications to avoid any complications, including permanent bone mass loss. Medications include bisphosphonates, such as ibandronic acid and alendronic acid. However, it is important to note that prescription medication is not required for every patient with osteopenia.

Preventing Osteopenia:

The best way to prevent osteopenia is by modifying lifestyle habits, and dietary habits, and engaging in physical activities. The following are some preventive tips to reduce the progression of osteopenia:

• Eating a balanced and healthy diet.

• Getting regular exercise.

• Avoiding tobacco exposure.

• Quitting smoking.

• Limiting alcohol use.

• Getting vitamin D and calcium through diet and supplements.

• Getting small amounts of vitamin D from sun exposure.

 

 

 

The Bottom Line:

Osteopenia most frequently affects people over 50 years old and women entering menopause. Certain unhealthy lifestyle habits, including smoking, tobacco exposure, eating disorders, and physical inactivity increase the likelihood of osteopenia in older adults. To stop and slow down the progression of osteopenia to osteoporosis, it is important to eat a balanced diet rich in vitamin D and calcium, exercise regularly, quit smoking, and take vitamin D and calcium supplements. 

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