Bones, Joints, and Osteoporosis 

Osteoporosis (porous bone) is a disease in which bone becomes fragile and susceptible to fracture. The Bone Health and Osteoporosis Foundation (BHOF) estimates there are 54 million Americans who have the disease. They project that of people 50 and older, one in two women and one in four men will break a bone due to osteoporosis. 

What is Osteoporosis? 

Bone is living tissue. It is constantly being absorbed and replaced. Osteoporosis occurs when the creation of new bone cannot keep up with the removal of old bone. As people age, bone mass is lost faster than it is created. Under a microscope, healthy bone looks like a honeycomb. A bone with osteoporosis has much larger holes and spaces. The bone has lost density or mass, bone tissue has deteriorated, and the bone has become weaker. The result is a bone at risk of fracture. Fractures of the hip, wrist, and spine are most common with osteoporosis. 

Who Is at Risk? 

Men and women of all races are affected by osteoporosis. Caucasian and Asian women who are past menopause are at the highest risk. According to the Mayo Clinic, women who went through early menopause, took corticosteroids for months at a time, or have a family history of hip fracture are at high risk and should see a doctor. The reduction of estrogen levels at menopause is one of the most substantial risk factors for developing osteoporosis.  

Likewise, men experience lower levels of testosterone as they age, which increases risk. People with a small body frame tend to have a higher risk because they have less bone mass to draw from as they age. Also, an overactive thyroid or overmedication for an underactive thyroid has been associated with osteoporosis. According to the Mayo Clinic, dietary factors, including low calcium intake, eating disorders, and gastrointestinal surgery, increase the risk of osteoporosis. 

Can I Feel It in My Bones? 

People cannot necessarily feel their bones getting weaker and may not know they have osteoporosis until they break a bone from a minor fall. Even a simple action, such as bending over to pick up a newspaper, can cause a break. Some breaks can occur spontaneously for people with osteoporosis. Fractures of the spine may cause severe back pain, loss of height and/or kyphosis, and exaggerated posterior curvature of the thoracic spine, commonly known as humpback, stooped posture. 

Osteoporosis and its Relationship to Blindness and Low Vision 

After a first fracture, effective treatments can decrease the risk of further fractures. Osteoporosis can be diagnosed, treated, and prevented before any fractures occur. Fall prevention is particularly important for those with the disease. Precautions include:  

  • removing household hazards,  
  • installing grab bars,  
  • wearing well-fitting shoes,  
  • using handrails on stairs and  
  • using caution when taking medications causing drowsiness  

According to the Centers for Disease Control and Prevention (CDC), more than one-third of adults ages 65 and older fall annually in the United States. People who are blind or low vision are almost twice as likely to experience multiple falls as those who are fully sighted. 

Bone Density Tests 

A bone density test (BMD) can determine if medication is needed to prevent further bone loss. The BMD is recommended for women aged 65 or over and men aged 70 or over. Medication can slow bone loss and speed up new bone formation. 

Supplements and Food 

Calcium and vitamin D are also important in preventing and slowing the progression of osteoporosis. For people 71 or over, the BHOF recommends a daily diet of 1,200 mg of calcium. For some individuals, this may be difficult to achieve without supplements. Vitamin D makes it possible for the body to absorb calcium from food. Some Vitamin D can be obtained through the skin from direct sunlight. People are encouraged to limit sun exposure due to the risk of skin cancer. Most people need to take a vitamin D supplement. Check out the chart and information about foods high in calcium. 

Exercise 

The BHOF recommends regular weight-bearing and muscle-strengthening exercises along with the avoidance of excessive alcohol use and smoking as a part of treatment for osteoporosis. Exercise is an important part of treatment for osteoporosis and should be discussed with your physician. Activities involving twisting or impact may need to be curtailed, while regular weight-bearing and strengthening exercise is often advised under a doctor’s recommendation. 

Beneficial Exercises for People with Osteoporosis 

  • Weight-bearing exercise causes the bones and muscles to work against gravity. Some examples of potentially appropriate weight-bearing exercises are walking and dancing. 
  • Strengthening exercises might include lifting weights, using resistance machines, circuit machines, exercising bands, and Pilates. Swimming provides resistance and strengthening. 
  • Balance exercises are a third form of exercise that helps prevent falls and fractures. These include tai chi, yoga, balance boards, Pilates, karate, and dance. 

Be sure to check with your doctor before undertaking any exercise program. 

Exercising and Preventing Falls When Blind or Low Vision 

Protect Your Independence: Create a Fall Prevention Plan  – ConnectCenter (aphconnectcenter.org) 

The White Cane: A Tool for Fall Prevention – ConnectCenter (aphconnectcenter.org) 

Fall Prevention: Interventions for Older Individuals who are Visually Impaired – The National Research & Training Center on Blindness & Low Vision (instructure.com)