Ageing is often accompanied by an increased risk for various health conditions, among which osteoporosis and osteoarthritis are particularly common. Although these two conditions differ in nature, they can coexist and significantly increase the risk of falls and fractures among seniors. According to the World Health Organization (WHO), about 73% of people living with osteoarthritis are over the age of 55, and 60% are female. Additionally, studies by the WHO also highlight that the prevalence of osteoarthritis is expected to continue to increase globally along with the increase in ageing populations and rates of obesity and injury.
By being aware of the impact and taking steps to prevent osteoporosis and osteoarthritis, seniors can continue to protect their independence and quality of life for the years to come. We discussed with rheumatologist Dr. Anita Lim how to detect, prevent, and manage osteoporosis and osteoarthritis.
What are they?
Osteoporosis is the loss of bone mass that, over time, weakens bone structure and makes bones fragile. In contrast, osteoarthritis is a degenerative joint disease in which cartilage cushioning the ends of bones gradually wears away, resulting in ongoing pain and limited joint movement.
Osteoporosis is a condition where bone mineral density decreases and the bone microstructure changes. According to Dr. Anita, osteoporosis is often symptom-free until a fracture occurs.
“The first sign that you may have it is when you break a bone in a relatively minor fall or accident (known as a low-impact fracture),” she shares. “Fractures are most likely in the hip, spine, or wrist. Some people have back problems if the bones of the spine (vertebrae) become weak and lose height.”
In contrast, osteoarthritis is a chronic inflammation that commonly affects the joints due to damage in the cartilage. This affects weight-bearing joints like the knees or frequently used joints such as the joints of the hands. Symptoms include joint pain, stiffness of the affected joints, and swelling, with discomfort worsening after movement or at the end of the day.
“Your joints may feel stiff after rest, but this usually wears off quickly once you get moving. Or you may find that your symptoms vary depending on what you’re doing,” Dr. Anita explains. She also elaborates on the type of swelling your affected joints may experience. “The swelling may either be hard and knobbly, especially in the finger joints, caused by the growth of extra bone or soft, caused by thickening of the joint lining and extra fluid inside the joint capsule.”
Causes and Early Signs
Osteoporosis develops from progressive bone loss and deterioration of the microarchitecture of the bones. Over time, this increases the risk of vertebral, hip, and wrist fracture. The condition is influenced by hormonal changes (especially oestrogen deficiency in postmenopausal women), low calcium and vitamin D intake, a sedentary lifestyle that leads to diminished bone remodeling, certain medications, and pre-existing conditions such as hyperthyroidism.
Osteoarthritis results from cumulative joint stress and damage. It may be caused by repetitive joint use or injury leading to wear and tear of the cartilage, age-related cartilage decline, excess weight increasing the mechanical load on weight-bearing joints, a genetic predisposition to the condition, and low-grade chronic inflammation, which may contribute to cartilage breakdown.
Osteoporosis is often silent until fractures occur. However, you may notice early warning signs, such as a stooped posture and loss of height due to the curving of your spine. Meanwhile, the initial symptoms of osteoarthritis include joint pain, stiffness after rest, swelling, and a grating sensation during joint movement.
Risk Factors
Certain risk factors associated with osteoarthritis and osteoporosis are age, genetics, hormonal changes, poor nutrition, obesity, and chronic inflammatory conditions that elevate the risk of developing osteoporosis and osteoarthritis.
Dr. Anita notes that “a major injury or operation on a joint may lead to osteoarthritis in that joint later in life.” Fortunately, normal everyday activities and exercises don’t cause osteoarthritis, but very hard and repetitive exercises or physically demanding occupations may increase your risk of developing the condition.
Seniors may experience both conditions simultaneously, as they share risk factors such as ageing and a sedentary lifestyle. In some cases, osteoarthritis may be associated with increased bone density (sclerosis) in affected joints, while osteoporosis is characterized by overall decreased bone mass.
“When present together, the risk of falls and fractures increases, and the clinical management may become more complex because joint pain and reduced mobility from osteoarthritis can further limit physical activity, thereby exacerbating bone loss in osteoporosis,” Dr. Anita elaborates.
Impact of Chronic Illnesses on Osteoporosis and Osteoarthritis
Chronic illnesses can worsen osteoporosis and osteoarthritis by affecting bone strength and joint health. “These conditions can alter inflammation, hormone levels, and metabolism, making bones weaker and joints more prone to damage,” notes Dr. Anita.
This makes managing osteoporosis and osteoarthritis more complex by increasing the risk of fractures, joint pain, and mobility limitations, which highlights the need for careful, comprehensive care.
Key chronic illnesses include:
Maintaining Bone and Joint Health
Aside from traditional medicine, Dr. Anita shares several alternative and holistic ways to manage your bone and joint health:
“While osteoarthritis is a degenerative condition, lifestyle modifications such as regular exercise, weight loss, and proper joint care can reduce symptoms, improve joint function, and potentially slow disease progression,” Dr. Anita notes, emphasizing the importance of managing these conditions.
Those already suffering from osteoporosis and osteoarthritis should also take note to not overindulge in habits that may worsen their symptoms. High intake of sugar and saturated fats can promote inflammation, while excessive caffeine, smoking, and alcohol intake contribute to bone loss and joint deterioration.
Screening and Treatment Options
As osteoporosis and osteoarthritis are more prevalent in women, it is recommended to start screening at age 50, or younger if risk factors are present. These risk factors include premature menopause, family history, previous fractures, and long-term steroid use.
Meanwhile, men are recommended to start screening typically from age 65 onwards, or earlier for those with risk factors.
Advances in Treatment
Ageing does not have to mean inevitable falls or fractures. By understanding the risks associated with osteoporosis and osteoarthritis and adopting proactive lifestyle strategies, seniors can protect their bone and joint health, maintain mobility, and live independently for longer.
