Osteoporosis is a disorder which leads to increased skeletal fragility causing a noticeable reduction in bone strength and density. This loss can mean that fractures happen with very minimal trauma. It is one of the most highly prevalent diseases in the world and is regarded by the World Health Organisation as a serious concern. Recent estimates show that over 200 million people around the globe suffer from osteoporosis. Before the age of 50 this can be broken down into 1 in every 40 women and 1 in every 60 men after the age of 50 the incidence rate rapidly increases to 1 in every three women and 1 in every five men. There are four main types of osteoporosis primary, secondary, idiopathic juvenile and osteogenesis imperfecta.
Type 1 or primary osteoporosis is the most common form osteoporosis that affects people. This form of osteoporosis most often is found in women. In women the condition indicates the trabecular bone being lost soon after menopause. As the levels of oestrogen naturally begin to decrease between 45 to 55 years of age, there is an increase in bone resorption causing a loss of bone strength and density. Men are also affected by this but at a later stage due to the differing thickness of the bones. Women naturally possess thinner bones which causes them to lose bone mass more quickly. Age is the sole reason for individuals being afflicted by this form of osteoporosis.
Type 2 or secondary osteoporosis is very similar to Type 1 in symptoms however the manner of affliction is different. Unlike Type 1 osteoporosis, Type 2 can happen at any age. This form of the disease is a resulting factor of some medical conditions. Illnesses such as leukaemia, hyperparathyroidism and hyperthyroidism can all increase the risk of individuals developing osteoporosis. Alternatively, Type 2 can be caused by certain medications. Corticosteroids are used to alleviate inflamed sections of tissues and prescribed to people with asthma. Prolonged usage can lead to what is known as steroid-induced osteoporosis (SIOP). SIOP occurs as the steroid causes an inhibitory effect on osteoblasts which help with bone formation. Unfortunately, the steroid also increases the rate of bone resorption which is one of the primary causes of osteoporosis.
Idiopathic juvenile osteoporosis or IJO is a rare form of osteoporosis that only occurs in young children usually at the onset of puberty. It has no known causes. The condition often manifests between the ages of 8 and 14 years old. A minimal amount of bone formation is an exclusive characteristic of this form of osteoporosis. Physical deformities associated with this type of osteoporosis include kyphosis, limps or a sunken chest. In all cases but the most severe, these issues are reversible through planned exercises. Children affected may experience abnormal development. Normal growth could be undermined during the acute phase of the condition, however, continues after the disease runs its course. While most individuals afflicted by the disease go on to make full recoveries, it can lead to permanent disability with the upper spine becoming curved (kyphoscoliosis).
Another rare form of osteoporosis is osteogenesis imperfecta (OI). This type of osteoporosis is a genetic disorder and so is apparent from birth. Individuals with a family history of OI make up 65% of reported cases. One defining characteristic of OI is the affected individual will have a low quantity or quality of bone collagen. As the disease is present from birth, the chance of achieving average bone mass is slim, as a direct result many children diagnosed with OI develop secondary osteoporosis later on in life. As both IJO and OI are similar gene tests or bone biopsies may be carried to help differentiate between the two conditions.
Osteoporosis commonly leads to fractures of the hip, spinal and wrist regions. Age is the most significant contributing factor in increasing the severity of osteoporosis. As we get age, fractures become more commonplace regardless of gender. Spinal fractures often can lead to severe issues such Dowagers hump (a type of spinal deformity) or in worse case circumstances paralysis or death. By 2050 fractures are expected to rise by 310% for women and by 250% for men, 53.9 million individuals are estimated to experience a fracture in 2050.
One of the most affected countries is the UK. Within the UK alone around 2 million people were reported to be suffering from the disease last year, almost double that of people living with dementia. 300,000 fractures get recorded each year; these can cause significant pain, disability and in some cases death, around 1150 people die a month following a fracture. This places a tremendous strain on the provision of healthcare services within the UK. Older people with a single or multiple long-term conditions including osteoporosis are estimated to make up 70% of all admissions and total NHS spending. Around £1.5 billion pounds are reported to be spent on ailments such as osteoporosis each year.