Silent Disease of Elderly

The saying “Old age cometh not alone” is as true as always it brings with it many changes in body and skeleton. An elderly person suffers a fall and fracture without any prior symptoms of osteoporosis the most common bone disease. Osteoporosis (porous bones) is defined as a progressive thinning of bone and loss of bone mineral. Osteoporosis can be present in aged person from many years without any symptoms that would prompt to seek medical advice. Hence it is called a silent disease as a result of silent bone loss.

           

Osteoporosis is a major public health problem and there are over 120 million osteoporotic patients in the world today. Scientific data indicate that bone mass is lower at the younger age in women in India than Western countries. Osteoporotic fractures typically involve the wrist, spine or hip.

           

Once the infant is born, bone continues its growth and the peak bone is attained around the age of 30. The peak bone mass is measured as bone mineral density (BMD) by bone densitometers. Osteoporosis is inevitable but, it can be postponed by attaining higher bone mineral density at young age. Calcium is the major mineral present in bone. Higher calcium intakes and exercise in young age increases the bone mineral density.

           

Women are at higher risk of osteoporosis due to low bone mass, multiple pregnancies, low calcium intakes and early onset of menopause. In women, estrogen (female hormone) is known to promote bone growth. Its deficiency, during post menopause, they lose bone mass more rapidly hence, the risk of osteoporotic fractures are higher then in men. Further increased risk of osteoporotic fractures occur equally in men and women aged 70 and above.

           

Osteoporosis is a preventable and treatable disorder to some extent. Proper dietary and exercise habits in elderly help maintain bone integrity and reduce bone loss with ageing. Elderly must consume one glass of milk and calcium supplement of about 500 mg of Ca/day to meet the calcium requirements of the body. 

           

The osteoporotic patient should limit alcohol and caffeine (one cup of coffee) and restrict salt intake in order to limit the calcium losses. Female patients of osteoporosis should aim for a total calcium intake from diet and supplements up to 100 mg/d in 3 divided doses.

Foods rich in calcium                                    Nutrient content / 100g of edible portion  

1. Ragi                                                             344 mg

2. Green leafy vegetables                                           500 – 800 mg

3. Gingelly seeds                                                        1450 mg

     Cumin seeds                                                          1080 mg

4. Cheese, Khowa, skimmed powder

     and whole milk powder                                          790 – 1370 mg

5. Fish & dry fish                                                         843 mg

           

By Dr. C. Vijaya Kumar Reddy, M.sc., Ph.d,,

Rtd. Bio-Chemist

National Institute of Nutrition (ICMR)

Hyderabad.

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