Heal

Fragile and vulnerable

WE have all seen it — the elderly aunt, sister or mum whose life takes a drastic turn when she suffers a hip fracture.

They spend the rest of their years bedridden or wheelchair-bound, their once-active lives taken away and it all boils down to bone health and strength.

Osteoporosis is a growing health concern in Malaysia with an estimated 77 per cent of Malaysian women living with post-menopausal osteoporosis.

It's a disease that remains underdiagnosed and undertreated, with very little data on its prevalence despite the huge impact it has on a woman's life.

It's a silent disease with no symptoms and often goes unnoticed until patients experience a fracture. Globally, osteoporosis causes more than 8.9 million fractures every single year.

Malaysian Osteoporosis Society president Professor Dr Chan Siew Pheng says that as its name suggests, osteoporosis means the bones are porous.

When patients have osteoporosis, their bones tend to fracture relatively easily. Just a little fall or bump and fractures happen. Sometimes, it doesn't even require a fall. Merely bending over to carry a grandchild or a heavy flower pot may cause them to fracture the spinal vertebrae.

Insufficient calcium and vitamin D are factors that put one at risk of osteoporosis. Being sedentary, not exercising, over-consumption of alcohol and smoking are other risk factors, but there are also some women who have a genetic predisposition for the disease.

"Calcium is the element that gives bones the strength it requires so if you have lots of calcium leaching out of the bone, that leaves you with a bone that is relatively weak," explains Dr Chan.

Increasing age also puts a woman at risk and particularly if her mother or grandmother has had hip fractures.

THE CONSEQUENCES

Dr Chan says one out of five patients who have hip fractures may die within a year. In fact, only about a quarter of them are able to eventually resume normal daily activities.

The majority will end up disabled, needing daily nursing care or even be placed in nursing homes.

Fragility Fracture Network Malaysia president, Datuk Dr Lee Joon Kiong says the increasing proportion of older persons in Malaysia underscores the need for urgent action to tackle the projected burden of osteoporosis.

It is necessary to educate the public, especially older people, that osteoporosis-related fractures are major health
problems.

"When an older person has a fall and suffers a fracture, surgery can be fatal due to their age and other health complications that arise. Bone fractures, particularly in the spine or hip, are the most serious complications of osteoporosis. This is made worse with existing health conditions such as high cholesterol and diabetes, or side-effects of surgery recovery due to prolonged bed rest," he explains.

Dr Lee adds that we have to stop believing the misconceptions about osteoporosis. People tend to assume it's a natural part of ageing, making it a neglected medical problem.

There are also those who believe that osteoporosis is not preventable or treatable, or that if you have osteoporosis, you don't need medicine, but only need to drink more milk and take more calcium and vitamin D.

These are all common misconceptions, stresses Dr Lee.

If you have osteoporosis, there are medicines to treat the condition to improve bone quality and density and to prevent fractures.

In high-risk individuals, bone mineral density measurement can be done. If you have low bone mass and a high risk for fractures, medicines are available to improve bone quality and density.

Treating osteoporosis at its earliest stages is the best way to prevent some of the more serious consequences of the condition. However, bone health checks are not usually part of annual health examinations for many people and they are unaware that consuming calcium-rich drinks and supplements alone are not enough, explains Osteoporosis Awareness Society of Kuala Lumpur and Selangor president, Choo Yem Kuen.

There is also a need to practise resistance exercises and get sunlight for natural Vitamin D that will help strengthen bone health, she adds.

PROMOTING BONE HEALTH

THE Osteoporosis Awareness Society of Kuala Lumpur and Selangor (OASKLS), Fragility Fracture Network Malaysia (FFNM), and Malaysian Osteoporosis Society (MOS) have signed a memorandum of understanding to officiate the formation of the Bone Health Alliance Malaysia (BHAM).

The collaborative partnership aims to pave the way for bone health education among local communities, correct the misconception that osteoporosis is unpreventable, organise meaningful stakeholder engagement, as well as enhance treatment and diagnosis with the purpose of improving patient outcomes.

As most patients only find out they have osteoporosis upon a fracture, BHAM emphasises the importance of considering your risk factors and planning your prevention strategy, channelling the message "Don't Wait 'Till It Breaks, Check Your Bones".

meera@mediaprima.com.my

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