By Alvin Lim

As the large number of baby boomers grow older, osteoporosis will become an increasingly important public health problem.

Post-menopausal women over 55 are the largest group at risk.

By the time they are in their 80s, about half in this group will have osteoporosis, said Dr Leslie Leong, consultant orthopaedic surgeon at Island Orthopaedic Consultants.

Osteoporosis is a disease of the skeleton in which bones become brittle and fragile from loss of bone density, typically as a result of hormonal changes or deficiency in calcium or vitamin D.

It leads to an increased risk of fragility fractures. A fragility fracture (from low trauma) occurs from a fall from standing height or less. Falls are also more common in the elderly and this adds to the risk of fractures. Hip and spine fractures are the most serious fractures associated with osteoporosis.

In the elderly, such fractures can mean considerable loss of function or even death.

Dr Leong said about 15 to 25 per cent of patients who suffer hip fractures die within one year. In comparison, the five-year mortality rate for stage two breast cancer patients is about 20 per cent.

"So you could say if you fractured a hip bone, especially in the elderly... it could be as lethal as advanced stage breast or colorectal cancer," said Dr Leong.

Dr Julinda Lee, consultant obstetrician and gynaecologist at Pacific Healthcare Specialist Centre, said adults usually reach a peak bone mass when they are about 30 to 35 years of age.

After that, a slow decline in bone mineral mass begins.

Poor nutrition or lack of exercise results in a poorer peak bone mass and quicker decline in bone health. Smoking and excessive consumption of alcohol and caffeine stimulate a quicker decline in bone mineral content and should be avoided.

Dr Lee said deteriorating bone mineral mass is usually "silent" unless a fracture occurs.

There are, however, four indicators: pain, loss of height, loss of function and a hunched back which may indicate multiple vertebral fractures.

Hence, a nutritious diet coupled with sufficient exercise is important for good bone health. Adequate intake of calcium, vitamin D and magnesium is important for the bones.

Eating green vegetables also helps cut down the acidity in body fluids and reduces bone loss.

Dr Lee recommends that physical activity be gradually introduced into family time.

If exercise is new to you, it is important to slowly introduce physical activity as weight-bearing exercises may increase the risk of joint injuries and accelerate osteoarthritis.

Dr Leong said: "With the exception of some who maintain a healthy amount of physical activity from middle age, most of the elderly lead sedentary lifestyles.

Unless something happens to them, they do nothing to maintain their health.

"It's about changing your mindset and not being complacent."