Causes of Osteoporosis in the Elderly

One of the key causes of osteoporosis in elderly people is a decrease in vitamin D levels in the body. This vitamin plays an important role in regulating calcium and phosphorus metabolism, helping their absorption from food and maintaining bone strength. Low vitamin D levels weaken bone mineralization, making bones more fragile and susceptible to fractures. Don’t even think that taking the best and most expensive vitamins will save you from this. Read on.

Vitamin D deficiency is directly linked to a lack of sufficient sunlight. The sun is a natural source of ultraviolet radiation necessary for the synthesis of vitamin D in the skin. In elderly people, due to health conditions, limited mobility, or lifestyle factors, time spent outdoors is often reduced. This leads to a lack of sun and, consequently, vitamin D, which negatively affects bone health. Let me clarify that elderly people, especially those living in the northern regions of our country (such as the Leningrad Oblast, Karelia, Novgorod Oblast, and other areas), due to age-related psychological changes, generally prefer to stay home and not go outside at all. There’s your sunlight deficiency.

This should be placed first. It accounts for a full 95% of the causes of this disease: lack of physical activity. Regular physical activity stimulates bone formation and helps maintain bone density through mechanical load on the skeleton. And what kind of activity does an elderly person have? They treat themselves like a crystal vase. The reduction in motor activity, characteristic of many elderly people due to lifestyle and age-related psychological changes, leads to bone tissue degradation. What to do? Any physical activity. If the person is bedridden, tap on their bones, their limbs, their spine.

Finally, monotonous diet. «Where does monotonous diet come from in the modern world?» you may ask. An elderly person gets used to eating the same favorite foods. Variety disappears. This causes a deficiency of certain vitamins or trace elements.

This condition can also be caused by various diseases, bone metastases, ulcers, wounds, bedsores. I won’t even mention genetic anomalies – that’s a topic for a separate article.

Prevention of Osteoporosis in Old and Advanced Age

However, there are effective preventive measures that help slow the progression of the disease and improve quality of life.

One of the key factors in preventing osteoporosis is regular physical activity. Moderate and systematic exercise, such as walking, or even just regular strolls, helps maintain bone hardness. This is a key factor. Without it, you can stop reading. In the past, traumatologists recommended tapping on the cast with a small hammer to help bones heal. See the logic? Vibration… it’s essentially physical activity. If necessary, you can even call a traumatologist to your home.

An equally important aspect of osteoporosis prevention is a varied and balanced diet. The diet of elderly people should include a variety of foods, not just their favorites. For bone fractures, I recommend increasing the intake of cottage cheese, eggs, dairy products, and jellied meat (or aspic – call it what you like).

One natural source of vitamin D is sunlight. It’s simple. Take the elderly person outside. Put them in the sun.

I won’t bore you any longer. Next, I’ll briefly go over medications. I should note right away: if we are talking about a relatively healthy person, you should not take any medication at all.

Medications for Treating Osteoporosis

The most commonly used drugs can be divided into several main groups.

Bisphosphonates are the mainstay of osteoporosis treatment. They suppress the activity of osteoclasts – the cells responsible for bone destruction – which slows down bone resorption. Classic representatives of this group are alendronate, risedronate, and ibandronate. Their use leads to a significant reduction in the frequency of fractures, especially vertebral and hip fractures. The best effect is achieved with long-term, regular use. However, in elderly patients, it is important to consider contraindications and possible side effects such as dysphagia or heartburn. Honestly… I have heard of these drugs being used in cancer patients as prescribed by an oncologist. I have never heard of a traumatologist prescribing such drugs.

The second most important group is selective estrogen receptor modulators (SERMs) , such as raloxifene. These drugs mimic the positive effects of estrogen on bone tissue, which is especially relevant for postmenopausal women, in whom the decline in sex hormone levels is a key factor in the development of osteoporosis. Raloxifene not only improves bone density but also simultaneously reduces the risk of certain cancers, such as breast cancer.

Hormone therapy is relevant for the treatment of osteoporosis in elderly women with severe estrogen deficiency. However, this method has contraindications and may increase the risk of cardiovascular complications and cancer, so it is prescribed strictly individually and under medical supervision.

An innovative approach is the use of drugs that stimulate bone formation. For example, teriparatide – an analog of parathyroid hormone – activates osteoblasts, the cells that build bone matrix. Its use does not just slow resorption but actually increases dense, strong bone, which is especially important in cases of severe osteoporosis with a high risk of fractures.

Calcitonin, a thyroid hormone, has also been used to treat osteoporosis because it reduces osteoclast activity. However, in modern practice, its use is limited due to lower efficacy and the development of better alternatives.

An important addition to drug treatment is the correction of vitamin D and calcium deficiency. A lack of these substances impairs bone mineralization, reducing the effectiveness of the primary therapy. Vitamin D3 and calcium supplements are recommended for most osteoporosis patients, especially when deficiency is confirmed.