During growth, new bone material is continuously being formed and old material lost to maintain normal and strong bones. Some minerals such as calcium and phosphates play a vital role in building strong bones, among others.

As we age, the rate at which old bone material is lost exceeds the rate at which it is formed failing to strike a balance, hence our bones gradually wear out and progressively become abnormally thin, weakened, and hence can easily get broken (fractured). For instance, one can easily break a bone after a light fall even at home. Breaking a bone can be serious, especially if the bone is in the hip. People who break a hip sometimes lose the ability to walk on their own

The leading cause of this age related bone weakness is a lack of certain hormones, particularly estrogen in women and male hormones in men which greatly help in maintaining bone mass. Women, especially those older than 60 years of age, are frequently diagnosed with the disease

Women are at a greater risk than men, especially women who are thin or have a small frame, as are those of advanced age.

Women, who are postmenopausal including those who have had early or surgically induced menopause after surgical removal of ovaries for whichever reason, are at increased risk. Abnormal or absence of menstrual periods is a risk too.

Cigarette smoking, eating disorders such as anorexia, low amounts of calcium in the diet, heavy alcohol consumption, inactive lifestyle, and use of certain medications such as corticosteroids and anticonvulsants, are also risk factors.

Suffering from rheumatoid arthritis is a risk factor for developing this age related bone loss, and having a parent who has/had age related bone fractures is a risk factor for the offspring as well.

This age related bone loss is a silent disease and does not usually cause any symptoms until one breaks a bone.

Fortunately, preventive treatments are available that can help to maintain or increase bone density. For those already affected, prompt diagnosis of bone loss and assessment of fracture risk are essential because therapies are available that can slow further loss of bone or increase bone density.

A recommended diet for maintaining strong and healthy bones includes consuming an adequate number of protein and calories as well as optimal amounts of calcium and vitamin D, which are essential in helping to maintain proper bone formation and density. Main dietary sources of calcium include milk and other dairy products, such as cottage cheese, yogurt, or hard cheese, and green vegetables, such broccoli. Sometimes calcium supplements may be prescribed for women who cannot get enough calcium in their diet

Exercise may decrease fracture risk by improving bone mass in young women and helping to maintain bone density for women after menopause. Exercises decrease the tendency to fall due to weakness as well. Physical activity reduces the risk of hip fracture in older women as a result of increased muscle strength. It is recommended that one exercises for at least 30 minutes a day on most days of the week.

Cigarette smoking cessation, avoiding alcohol consumption and drugs such as steroids reduces ones risk of bone loss.

It is however important to note that the benefits of exercise are easily lost when a person stops exercising. A regular, weight-bearing exercise regimen that a person enjoys improves the chances that the person will continue it over the long term

There are medicines that your doctor may prescribe to reduce bone loss, increase bone density or keep it about the same, or reduce the chances that you will break a bone.

Since this condition rarely presents any symptoms until one breaks a bone, any one above 60 years of age or even younger with a higher risk of this age related bone loss should go for routine medical checkups for early detection and intervention of this condition. The doctor will find out if you have the condition by taking history, physical examinations and some investigations such as special forms of X rays and some blood lab investigations.

However, prevention of this age related bone condition is very preferable to treatment because bone loss changes are quite irreversible and although treatment may stabilize or increase bone density and reduce the risk of fracture, it is unlikely to fully restore normal bone quality and bone strength.

Dr. Ian Shyaka is a General Practitioner at Rwanda Military Hospitaliangashugi@gmail.com