Three Proven Ways To Support Parents With Osteoporosis!

Watching your parents grow older and more frail, or start to experience falls or other medical events, can feel extremely frightening for a child who wants to do everything they can to support their parents’ long-term health and well-being. A diagnosis of osteoporosis can be especially frightening, given that:

● It’s very common – with over 1.2 million Australians currently diagnosed with poor bone health and an estimated 6.2 million Australians in total living with poor bone health including osteopenia (considered a precursor to osteoporosis).

● Having osteoporosis means that your risk of having a bone fracture from a minor incident, even from bumping your hip against a table, increases exponentially.

● Those with osteoporosis and the resulting fractures are shown to be linked to a lower quality of life , poor health status, impaired physical function and increased pain.²

● Falls are the leading cause of injury-related deaths among older people, with osteoporotic poor bone health often being the culprit.³

Understanding Osteoporosis In Older Adults

Osteoporosis is characterised by a decrease in bone mineral density, the porous filling of your bones, which makes bones weaker and more susceptible to fractures. While it can affect individuals of all ages, older adults are at a much higher risk because of the natural effects of the ageing process. Specifically, as we age, the rate at which our bodies form new bone tissue slows down, and the rate of bone resorption (or breakdown) increases. This imbalance of bone loss vs new bone formation leads to more bone being lost overall over time, which is a key factor in the development of osteoporosis. In women, this process can accelerate after menopause when estrogen levels decline, as estrogen plays a vital role in maintaining bone density.

Older adults may also have accumulated a lifetime of factors that can negatively impact bone health. Poor dietary habits, inadequate intake of essential nutrients like calcium and vitamin D, and a sedentary lifestyle can all contribute to decreased bone density. Additionally, certain medical conditions, medications, and lifestyle choices, such as smoking and excessive alcohol consumption, can further exacerbate the risk of osteoporosis in older adults.

The consequences of osteoporosis in older adults can be severe. Fractures, particularly hip fractures, are a significant concern, as they can lead to immobility, reduced independence, and a decline in overall

^[1] https://www.tandfonline.com/doi/full/10.1080/21556660.2019.1677674

^[2] https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-019-1268-y

^[3]https://www.bonehealthandosteoporosis.org/news/falling-can-be-fatal/

quality of life. Studies have also linked hospitalisations due to hip fractures with a significantly increased risk of mortality. Fractures can also increase the risk of other health complications, such as infections and pneumonia, which can be especially dangerous for older adults.

1. A Home Assessment And Home Modifications

While most people jump straight to bone health management when it comes to supporting their parents and loved ones that are living with osteoporosis, a home assessment and evaluation of potential home modifications is a simple and effective way to reduce one of the biggest risks associated with osteoporosis: a fall and subsequent fragility fracture.

During a home assessment, a trained professional such as an occupational therapist, visits a person’s home to evaluate its safety and identify any potential hazards. They carefully assess various aspects of the home, including the layout, flooring, lighting, furniture arrangement, and accessibility features. The goal is to identify any areas that may pose a risk for falls or injuries and to recommend appropriate modifications to enhance safety.

Flooring is a crucial element that can significantly impact fall risk. The home assessor will look for loose rugs or carpets, uneven surfaces, or slippery areas and suggest remedies like securing rugs with non-slip backing or choosing flooring materials with better traction. They may also recommend removing obstacles or clutter from pathways to prevent accidental tripping.

Lighting is another essential factor in fall prevention. Inadequate lighting can make it challenging for older adults to see potential hazards, increasing the risk of falls. The home assessor may suggest installing additional lighting fixtures or using brighter bulbs in areas prone to poor visibility, such as staircases, hallways, and bathrooms.

Home assessments also consider the accessibility and usability of the home for individuals with mobility challenges. This may involve evaluating the need for handrails or grab bars in areas like the bathroom or near staircases to provide support and stability. Installing these aids can make a significant difference in preventing falls and promoting independence for older adults with osteoporosis.

Furthermore, the home assessor will examine the furniture arrangement to ensure that it allows for ease of movement and navigation. They may recommend rearranging furniture to create clear pathways and ensure that there are no obstructions that could lead to tripping or falling accidents.

By conducting a home assessment, older adults with osteoporosis can benefit from personalised recommendations that address their specific safety needs. The modifications and adjustments suggested by the home assessor are tailored to the individual’s home environment, lifestyle, and mobility requirements. This personalised approach maximises the effectiveness of fall prevention strategies and promotes confidence and independence in daily activities.

In addition to reducing the risk of falls and fractures, a home assessment can have a positive impact on the emotional well-being of older adults. Feeling safe and secure in their home environment can alleviate anxiety and fear, leading to improved overall quality of life. Moreover, the proactive approach of conducting a home assessment empowers older adults to take control of their safety and well-being, reinforcing a sense of autonomy and self-reliance.

2. Lifestyle Changes

The next proven way to help with osteoporosis is through lifestyle changes – which includes dietary changes, regular exercise, and adding certain medications into the day if prescribed by your parent’s doctor. While the evidence is strong here, there are some notable challenges, too.

Diet
A balanced diet, particularly with regards to calcium and vitamin D intake, is widely documented in assisting with healthy bone development and osteoporosis prevention. When the body is low in calcium, it will take it from the bones, decreasing bone mass and initiating or worsening osteoporosis. Between 1000-1200mg per day is recommended for men and women aged over 50 years and varies depending on other medical conditions, weight and age.

Research has found that calcium is best absorbed through the foods we eat and the beverages we drink, and supplements can have many negative health implications⁴, so it’s best to encourage your parents to focus on meeting their calcium needs through their diet.

● Dairy products are the richest source of calcium, and just two to three servings per day, e.g. a cup of milk, a pottle of yoghurt or two slices of cheese, can provide adequate calcium intake for most people.⁵

● Other high calcium sources include almonds, oranges, dried figs, soybeans, garbanzo, white and pinto beans, and leafy green vegetables such as kale and spinach, among others.

● Dairy products also provide a range of other beneficial nutrients for bone health, including protein, vitamin B-12, phosphorus, potassium and riboflavin,⁶ and yoghurt that contains prebiotics and probiotics also improve intestinal calcium absorption and bone metabolism⁷

● Interestingly, high calcium intake from supplements have been shown to increase the risk of developing kidney stones, whereas a high dietary calcium intake may prevent kidney stones⁸

^[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400143/

^[5] http://www.nutritionfoundation.org.nz/nutrition-facts/minerals/calcium

^[6]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400143/

^[7] https://pubmed.ncbi.nlm.nih.gov/28823001

^[8]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5768298/

Vitamin D is also essential for healthy bone development and maintenance due to its role in calcium absorption and other complex mechanisms. When Vitamin D levels are low, osteoclast cells are triggered to release calcium from the bones and out into the blood. The recommended intake of vitamin D ranges between 800-1000 IU, and most people can achieve adequate vitamin D levels by simply spending time outdoors during the day. In the height of summer, as little as six to eight minutes of sun exposure⁹ may be sufficient to produce 1000 IU of vitamin D, though people with darker skin may require three to six times more sun exposure. It’s important to remember that your skin needs to be exposed to direct sunlight to allow the synthesis of vitamin D to occur, as both glass and SPF sunscreens block UV-B rays. So visiting your parents and getting out in the sunshine, followed by a calcium-rich meal together, is a fantastic way to help support their bone health.

Challenges associated with a diet-based approach do include that older adults do tend to have less ‘variety’ in their diets, have greater difficulty cooking meals, have greater difficulty getting out to the supermarket to do their food shopping, and have smaller appetites overall. This is where supermarket delivery orders of milk, cheese and yoghurts could be a good solution, so they have the right foods available to them at all times.

Exercise
Exercise is also currently recognised as a key ingredient in helping to support bone health as well as a person’s overall well-being, from their muscle strength to their balance and weight management.
● Strength-training and weight-bearing exercise is the most evidence-based treatment and prevention method for osteoporosis, and this includes jogging, dancing, or other sport or gym activities        that build muscle strength.¹⁰

● Through strengthening the muscles and enhancing balance, a person is less likely to experience falls¹¹

● To best benefit from the results, the National Osteoporosis Foundation recommends skeletal loading with high and low-impact weight-bearing exercises for at least 30 minutes per day, 5–7 days      a week.¹²

Unfortunately, the downside with exercise for older adults is that:

● You’ve got to be physically capable to do it. Intense physical activity is often not a realistic nor achievable approach for those aged over 50, or who have underlying musculoskeletal or metabolic conditions, as it could cause further harm.

^[9]https://bpac.org.nz/BT/2015/April/docs/BT26-laboratory-investigations.pdf

^[10]https://pubmed.ncbi.nlm.nih.gov/30814687/

^[11]https://www.ncbi.nlm.nih.gov/books/NBK279529/

^[12]https://cdn.nof.org/wp-content/uploads/2016/02/Exercise-for-Your-Bone-Health.pdf

● Making the time and effort to exercise, while keeping up the motivation to do it regularly, is often easier said than done for older adults and follow-through rates can be low.
● Up to 50% of people have been shown to not complete their exercise programs when they’re prescribed as part of their rehabilitation by health professionals¹³ , and currently 85% of Australians are failing to meet the basic recommended exercise targets of at least 150 minutes per week.¹⁴ These percentages are likely to be higher for older adults who may be facing other mobility and health challenges

Medications
Another common management tool for osteoporosis is medication. While medicines such as Fosamax show promising results in helping reduce the prevalence of fractures, they are not without their limitations for older adults:
● Research has found that osteoporosis medication has poor patient adherence ^15,16 leading to poor outcomes. A study examining the attitudes and treatment patterns of Australian GP’s in treating osteoporosis found that in over 80% of cases where patients ceased their medication, prescriptions were not being followed up or continued, placing these people at risk of further fractures and suggesting that osteoporosis was undertreated and underdiagnosed.¹⁷

● Osteoporosis medications have many common side effects, including inflammation of the stomach or oesophagus (leading to pain, heartburn, nausea, vomiting, constipation or diarrhoea), headache or dizziness, mouth ulcers, and muscle and joint aches or swelling. Rarer but more severe side effects include jaw osteonecrosis (bone death around the jaw), blurred vision, skin reactions and upper thigh bone fractures.^18,19

● Some osteoporosis medications can’t be taken for longer than one to two years as there haven’t been enough long-term studies for their safety. These often include bone-building medications, where studies have shown that the effects quickly stop working after you stop taking them. In this case, you will need to have taken other measures to promote your ongoing bone health.

3. Marodyne LiV

^[13]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856927/

^[14]https://www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-first-results/latest-release

^[15]Siris, E. S. et al. Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin. Proc. 81, 1013–1022 (2006).

^[16]Cramer, J. A., Gold, D. T., Silverman, S. L. & Lewiecki, E. M. A systematic review of persistence and compliance with bisphosphonates for osteoporosis. Osteoporos. Int. 18, 1023–1031 (2007).

^[17]https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-020-01103-2

^[18]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6533454/

^[19]https://arthritisaustralia.com.au/medication-search/bisphosphonates-oral/

Finally, the third proven way that you can support your parents that have been diagnosed with osteoporosis is by gifting them the Marodyne low-intensity vibration (LiV) device. Marodyne uses scientifically proven principles to stimulate bone formation and enhance muscle strength – all from the comfort of your parent’s own home and chair – even while they watch their favourite shows. Marodyne’s LiV therapy mimics the effects of weight-bearing exercises, promoting bone remodelling and muscle development.

Taking a closer look into how it works, Marodyne’s LiV device delivers mechanical signals to the musculoskeletal system, promoting bone and muscle health. The vibrations trigger the body’s natural bone-building response, leading to increased bone density and improved bone quality. By using the Marodyne LiV device regularly, seniors can experience the following benefits:

● Non-Invasive and safe: Marodyne is a non-invasive, safe, and drug-free option for improving bone health. It can be used at home, making it very convenient for older adults, and breaking down many of the ‘barriers’ associated with other treatment options.

● Enhanced bone density and strength: regularly using Marodyne’s LiV device can increase bone density and strength, reducing the risk of fractures.

● Improved muscle function: the device also enhances muscle strength and function, supporting overall physical performance and mobility.

● It’s user-friendly: Marodyne is a very user-friendly device that requires minimal effort – and there’s nothing complicated about getting started with it. Just 10 minutes of daily use can yield significant benefits.

● Expert endorsed: Marodyne has been recognised by the Royal Osteoporosis Society as a safe and effective tool for the prevention of osteoporosis and the improvement of bone health. Leading bone health experts, including Dr. Clinton Rubin, advocate for Marodyne’s effectiveness in supporting bone health. Marodyne has over 35 years of clinical studies and has been proven to help prevent osteoporosis in postmenopausal women and promote bone and muscle growth in younger osteoporotic women.

Marodyne LiV is available exclusively from Rehacare. To purchase the device, or for any questions, please contact Marodyne LiV Australia on 1300 653 522.