Osteoporosis Overview and Types
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Questions and Answers

What dietary change is most likely to reduce the risk of low BMD?

  • Increased intake of fruits and vegetables (correct)
  • High consumption of processed meats
  • Reduced intake of dairy products
  • Higher consumption of refined sugars

    • Which exercise type is suggested to help reduce bone loss in post-menopausal women?

  • Flexibility and stretching exercises
  • Combination of weight-bearing and resistance-strengthening exercises (correct)
  • Isometric exercises exclusively
  • Aerobic exercises only

    • What protein intake is associated with higher bone mineral density at the hip?

  • Exact RDA of 0.75 g/kg body weight/day
  • Higher than the RDA of 0.75 g/kg body weight/day (correct)
  • Lower than the RDA of 0.75 g/kg body weight/day
  • No specific protein intake is necessary

    • What was the effect of a calcium-rich diet over 30 days in a randomized controlled trial?

    <p>Reduction in bone turnover</p> Signup and view all the answers

    Which dietary pattern is linked with an increased risk of low BMD and hip fractures?

    <p>Meat/Western dietary pattern</p> Signup and view all the answers

    What characterizes osteoporosis as a disease?

    <p>Low bone mass and microarchitectural deterioration</p> Signup and view all the answers

    Which symptom is NOT typically associated with osteoporosis?

    <p>Severe joint swelling</p> Signup and view all the answers

    Which of the following is NOT a common area for osteoporosis-related fractures?

    <p>Shoulder</p> Signup and view all the answers

    What is the most common type of osteoporosis?

    <p>Postmenopausal osteoporosis</p> Signup and view all the answers

    What is a significant unchangeable risk factor for developing osteoporosis?

    <p>Gender</p> Signup and view all the answers

    Who is at the highest risk for developing osteoporosis?

    <p>Older white and Asian women</p> Signup and view all the answers

    Which medical condition is associated with an increased risk of osteoporosis?

    <p>Diabetes mellitus</p> Signup and view all the answers

    What lifestyle choice can increase the risk of developing osteoporosis?

    <p>Sedentary lifestyle</p> Signup and view all the answers

    Which of the following statements about osteoporosis symptoms is true?

    <p>Symptom development begins after significant bone loss.</p> Signup and view all the answers

    Which measurement technique is considered the reference for assessing bone mineral density?

    <p>Dual-energy X-ray absorptiometry (DXA)</p> Signup and view all the answers

    What does secondary osteoporosis result from?

    <p>Medications or other diseases</p> Signup and view all the answers

    What type of osteoporosis is characterized by rapid bone loss in women aged 51 to 75?

    <p>Type I osteoporosis</p> Signup and view all the answers

    What is one of the potential physical consequences of hyperkyphosis due to osteoporosis?

    <p>Cervical pain from head positioning</p> Signup and view all the answers

    Which statement correctly describes involutional osteoporosis?

    <p>It affects both men and women and is related to aging.</p> Signup and view all the answers

    How much can vertebral fractures and hyperkyphosis reduce a person's height?

    <p>About 10–20 cm</p> Signup and view all the answers

    Which of the following alcohol consumption levels is NOT associated with increased fracture risk?

    <p>One unit daily</p> Signup and view all the answers

    What T-Score indicates a diagnosis of osteoporosis?

    <p>≤ − 2.5</p> Signup and view all the answers

    Why is vertebral fracture assessment (VFA) recommended?

    <p>To identify undiagnosed vertebral fractures in high-risk individuals</p> Signup and view all the answers

    Which of the following is considered a first-line pharmacological treatment for osteoporosis?

    <p>Oral bisphosphonates like alendronate</p> Signup and view all the answers

    What is the scoring point for a participant who takes 9 seconds to complete the 4-meter walk?

    <p>1 point</p> Signup and view all the answers

    What is the recommended dietary intake of calcium for adults at risk of osteoporosis?

    <p>700 mg daily</p> Signup and view all the answers

    What combination may improve functions such as stair climbing and muscle mass?

    <p>Protein and Vitamin D combined</p> Signup and view all the answers

    What is the upper limit of alcohol intake recommended for individuals at risk of osteoporosis?

    <p>2 units/day</p> Signup and view all the answers

    Which intervention is proven to be the most effective non-pharmacological approach for managing sarcopenia?

    <p>Resistance exercise</p> Signup and view all the answers

    For individuals with vitamin D insufficiency, what is the minimum daily supplement they should take?

    <p>800 IU/day</p> Signup and view all the answers

    For the 3-meter walk, how many points does a participant receive if they complete it in 5 seconds?

    <p>3 points</p> Signup and view all the answers

    Which statement about non-pharmacological management of osteoporosis is true?

    <p>Regular exercise should be customized based on individual capability.</p> Signup and view all the answers

    What is the role of leucine-enriched protein supplementation in sarcopenia management?

    <p>It increases muscle mass and function.</p> Signup and view all the answers

    Which of the following is NOT a strong recommendation for managing osteoporosis?

    <p>Participating in regular online fitness classes</p> Signup and view all the answers

    What timeframe is generally needed to observe significant improvements from resistance exercise in sarcopenia management?

    <p>At least 3 months</p> Signup and view all the answers

    Which dietary component is noted to have unclear efficacy when used without exercise for sarcopenia management?

    <p>Nutritional intervention</p> Signup and view all the answers

    What current status exists regarding FDA approval for drugs treating sarcopenia?

    <p>No drugs are currently approved.</p> Signup and view all the answers

    What is the SMM index threshold for defining low muscle mass (LMM)?

    <p>8.90 kg/m2</p> Signup and view all the answers

    Which parameter is currently considered the most reliable measure of muscle function in diagnosing sarcopenia?

    <p>Low muscle strength (LMS)</p> Signup and view all the answers

    Which of the following is NOT a clinical symptom or sign warranting case-finding for sarcopenia?

    <p>Increased muscle mass</p> Signup and view all the answers

    What is considered severe sarcopenia?

    <p>Low muscle strength, low muscle mass, and low physical performance</p> Signup and view all the answers

    How is the score determined for the chair stand test in the SPPB?

    <p>Based on the time taken and use of arms to stand</p> Signup and view all the answers

    What gait speed defines low physical performance (LPP)?

    <p>0.8 m/s</p> Signup and view all the answers

    What is the maximum score possible for the repeated chair stand test?

    <p>4 points</p> Signup and view all the answers

    For confirmation of sarcopenia diagnosis, which combinations of parameters are required?

    <p>Low muscle mass and low muscle strength, or low physical performance</p> Signup and view all the answers

    Study Notes

    Osteoporosis

    • Definition: A progressive systemic skeletal disease, characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to increased bone fragility and susceptibility to fractures.
    • Osteoporosis causes bones to become weak and brittle, making them prone to fracture from a fall or mild stresses like bending or coughing. Common fracture locations are the hip, wrist, or spine.
    • It is a severe, chronic, progressive disease that is clinically silent, and is the most common metabolic bone disease.
    • Osteoporosis affects all races and sexes, yet white and Asian women, particularly those past menopause, have the highest risk.
    • Imbalance in bone cell function can also contribute to osteoporosis. It is referred to as the "silent epidemic" of the 21st century.

    Types of Osteoporosis

    • Primary osteoporosis includes idiopathic osteoporosis (in children and young adults, with unknown causes) and involutional osteoporosis (in both men and women, more related to aging).
    • Involutional osteoporosis is further divided into type I, or postmenopausal osteoporosis (mainly affecting women aged 51 to 75, characterized by rapid bone loss), and type II, or senile osteoporosis (occurring in those over 75, characterized by a loss of trabecular and cortical bone associated with aging).
    • Secondary osteoporosis accounts for less than 5% of cases, stemming from an underlying disease or medication. Postmenopausal osteoporosis is the most frequent kind.

    Symptoms of Osteoporosis

    • Early stages typically show no symptoms.
    • Later stages may manifest as back pain (from a broken or collapsed bone in the spine), loss of height over time, hyperkyphosis (increased outward curvature of the spine causing neck pain), and easy bone fractures. Osteoporosis-related breaks can result in vertebral fractures, and a decrease in height, as vertebral fractures and hyperkyphosis can result in a decrease in height of about 10-20 cm, approximately.

    Risk Factors of Osteoporosis

    • Unchangeable risks include sex (women more prone), age (risk increases with age), race (white and Asian women at higher risk), and family history of osteoporosis.
    • Changeable risks include smaller body frame size (related to less bone mass), inadequate calcium intake contributing to diminished bone density, early bone loss, and increased risk of fracture, eating disorders leading to underweight and weakened bones, gastrointestinal surgeries removing nutrient absorption surfaces (like calcium), and medication use (e.g., corticosteroids and other medicines).

    Hormone Levels and Osteoporosis

    • Hormones can play a role in osteoporosis risk. Lowered sex hormones weaken bones, especially estrogen loss during menopause in women, impacting bone density. Certain treatments for cancers (e.g., prostate or breast cancer) reduce testosterone or estrogen levels, accelerating bone loss.
    • Thyroid problems (hyperthyroidism) can also contribute to bone loss. Individuals taking too much thyroid medication or those with overactive thyroid glands may experience increased bone loss.

    Dietary Factors and Osteoporosis

    • A lifelong low calcium intake is a significant osteoporotic factor. Individuals with eating disorders or significant dietary restrictions or deficiencies in calcium, fruits, vegetables, and low-fat dairy products have increased risk of osteoporosis.
    • Gastrointestinal surgeries that reduce the gut's nutrient absorption, such as bariatric surgeries, limit the intake of calcium and may contribute to osteoporosis.

    Medical Problems and Osteoporosis

    • Certain medical conditions increase osteoporosis risk, including diabetes mellitus (types I and II), celiac disease, inflammatory bowel disease, kidney or liver disease, and rheumatoid arthritis.

    Lifestyle Choices and Osteoporosis

    • A sedentary lifestyle is linked to an increased osteoporosis risk.
    • Excessive alcohol intake, smoking, and other risk factors are associated with an increased fracture risk with increased osteoporosis.

    Complications of Osteoporosis

    • Fractures caused by minimal trauma are the significant consequence of osteoporosis and lead to pain, disability, reduced quality of life, and significant health risks. Hip fractures, particularly, are associated with higher mortality and lengthy hospitalizations.

    Assessment of Osteoporosis

    • Measurement of bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) is the major method for osteoporosis assessment.
    • Vertebral fracture assessment is also important, as these fractures frequently occur without symptoms and are significant osteoporosis predictors. Vertebral fractures should also be considered in high-risk individuals.

    Pharmacological Treatment for Osteoporosis

    • Bisphosphonates (e.g., alendronate) and intravenous zoledronate are common forms of osteoporosis treatment, considered cost-effective.
    • Hormone replacement therapy (HRT) and calcitriol (vitamin D3) are other treatment options.

    Non-Pharmacological Management of Osteoporosis

    • Healthy diets emphasizing calcium and vitamin D are useful for managing osteoporosis.
    • Regular weight-bearing and muscle-strengthening exercises are particularly crucial for improving bone density and preventing fractures.
    • Smoking cessation and alcohol reduction are also important steps for osteoporosis management.

    Sarcopenia

    • Sarcopenia is a geriatric syndrome characterized by progressive and generalized loss of skeletal muscle mass, along with decreased muscle strength, and physical function.
    • This reduces an individual's ability to perform daily tasks and increases the risk of falls and fractures.
    • Sarcopenia is often concomitant with osteoporosis and increases the associated health risks and complications.

    Diagnosis of Sarcopenia

    • The European Working Group on Sarcopenia in Older People (EWGSOP) outlined criteria, including measurement of low muscle mass, strength, and physical performance in older adults.

    Pathophysiology of Sarcopenia

    • Aging impacts the skeletal muscle's homeostasis, resulting in an imbalance between anabolic and catabolic processes in protein production.
    • Decline in muscle fiber size and number, infiltration of intramuscular and intermuscular fat, and diminished satellite cells are all contributing factors to muscle loss associated with sarcopenia.

    Management of Sarcopenia

    • Non-pharmacological interventions include exercise (especially resistance training) and proper nutrition (with an emphasis on adequate protein intake, vitamin D, sufficient antioxidants, and long-chain polyunsaturated fatty acids).
    • Nutritional and exercise interventions are effective and affordable sarcopenia progression prevention.

    Assessment Tools

    • The Short Physical Performance Battery (SPPB) is a method for assessing functional mobility, including balance, lower extremity strength, and walking capacity using standardized methods of assessment.

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    Related Documents

    Osteoporosis and Sarcopenia PDF

    Description

    This quiz covers the definition, causes, and types of osteoporosis, a progressive skeletal disease leading to increased bone fragility. Learn about its impact on different demographics and the clinical significance of this 'silent epidemic'.

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