Osteoporosis Case Study Research

Osteoporosis is a serious condition that affects elderly patients mainly. In this regard, the case of the female patient at the age of 65 is the case of the patient with osteoporosis, while the patient matches the major risk factors associated with the development of osteoporosis. Osteoporosis makes the patient susceptible to the risk of fractures because her bones become more fragile than they used to be before. The recovery of the patient in case of fracture will be longer compared to patents, who do not suffer from osteoporosis. Osteoporosis affects the quality of life of the patient and she needs the proper treatment which includes not only medication but also the change of her lifestyle.

Osteoporosis definition

Osteoporosis is a condition of the increased fragility of bones with the high susceptibility to fracture. Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses such as bending over or coughing can cause a fracture (Reginster, et al., 2006). Osteoporosis affects elderly patients mainly because their bones weight decreases and bones become more fragile than in the younger population.

Difference between osteopenia and osteoporosis

At the same time, the diagnosis of osteoporosis should also include the evaluation of the condition of the patient to distinguish osteoporosis from osteopenia. Osteopenia is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis. Therefore, oisteopenia involves the reduction of the density of bones but it is not as significant as is the case of osteoporosis.

Pathophysiology and epidemiology of the disease (osteoporosis)

Cosman and colleagues (2014) argue that the process of bone remodeling that maintains a healthy skeleton may be considered a preventive maintenance program, continually removing older bone and replacing it with new bone. Bone loss occurs when this balance is altered, resulting in greater bone removal than replacement. The imbalance occurs with menopause and advancing age (Cosman, 2014). Symptoms of osteoporosis include: back pain, caused by a fractured or collapsed vertebra, loss of height over time, a stooped posture, a bone fracture that occurs much more easily than expected.

Osteoporosis affects the elderly population, especially women because the risk of osteoporosis increases after menopause where the bone weight loss accelerates. The elderly population is also at the higher risk of fractures because they are susceptible to falls, while the development of osteoporosis increases the risk of fractures in case of falls. As a result, elderly patients suffer from the high risk of fractures and difficult recovery, if their condition is aggravated by osteoporosis.

The in-depth explanation for bone density and the relevant use for T-score interpretation

The bone density of the patient is compared to the average peak bone density of young adults of the same sex and race. This score is called the “T score” or T-score, and it expresses the bone density in terms of the number of standard deviations (SD) below peak young adult bone mass. Osteoporosis is defined as a bone density T score of -2.5 or below. Osteopenia (between normal and osteoporosis) is defined as bone density T score between -1 and -2.5 (Sorensen, et al., 2003). In such a way, T-score is indicative with regard to diagnosis of osteoporosis. It is important to note that while osteopenia is considered a lesser degree of bone loss than osteoporosis, it nevertheless can be of concern when it is associated with other risk factors. Therefore, T-score will show whether the patient has osteoporosis or osteopenia.

Bone mass decreases after the age of 35, while the bone loss occurs faster in women after menopause. Elderly patients become susceptible to the development of osteoporosis because their bone weight declines in the course of their aging. Women are at the higher risk compared to men. The development of osteoporosis also increases the risk of fractures because of low bone weight and their high fragility.  

The significant risk factors for this patient

The age of the patient is 65 that means that the risk of the development of osteoporosis is high. She had menarche at age 17 and menopause at age 42, while the bone loss after menopause accelerates that is another risk factor. The patient experienced menopause at the early age since the menopause normally occurs at the age of 50-55. Therefore, her bone mass decreased progressively since the age of 42 after the menopause. The age of the patient implies that her bone weight has started to decline fast after the age of 42 because menopause accelerates the decline of the body weight.

Furthermore, her body frame is another risk factor since the patient’s weight is 100lb and her height is 5’3”. Patients with small body frame are more likely to develop osteoporosis. Therefore, her condition and body frame indicate to the high risk of the development of osteoporosis. Moreover, she is in a risk group.

In addition, the current condition of the patient reveals the high risk of osteoporosis since the resent bone mass density report is significant for lumbar spine of -2.9 T-score and for hip bone of -3.3 T-score. Previous BMD results (at age 60) report for lumbar spine of -1.5 T-score and for hip bone of -1.7 T-score. T-score of the patient proves that she has osteoporosis because patients with T-score below -2.5 have osteoporosis.

The relevant treatment and prevention options for this patient

Cosman and colleagues (2014) argue that, according to current FDA-approved pharmacologic options for osteoporosis, the treatment should include bisphosphonates (alendronate, ibandronate, risedronate, and zoledronic acid), calcitonin, estrogen agonist/antagonist (raloxifene), estrogens and/or hormone therapy, tissue-selective estrogen complex (conjugated estrogens/bazedoxifene), parathyroid hormone 1–34 (teriparatide), and receptor activator of nuclear factor kappa-B (RANK) ligand inhibitor (denosumab). Akesson (2003) also points out that the treatment of the osteoporosis includes bisphosphonates, calcitonin, and selective estrogen receptor modulators, but sufficient calcium and vitamin D are a prerequisite. Therefore, both studies suggest similar approaches to the treatment of the patient with osteoporosis. Their findings are grounded on the evidence-based practice data obtained in the course of both studies. This means that their findings are grounded on the positive experience of health care professionals, who provide the treatment for patients with osteoporosis.

At the same time, the treatment of osteoporosis should not be limited to medication as the aforementioned studies suggest. In this regard, the recommendation of Akesson (2003) to take vitamin D is noteworthy since the use of vitamin can help to slow down the loss of bone weight. However, the patient will need not only medication but also non-medication treatment and change of the lifestyle. In this regard, the rise of the awareness of the patient of the high risk of fractures is very important because, in such a way, the patient may prevent the risk of fractures which is very high taking into consideration her age and her current condition.

Furthermore, the patient should consider changing her diet because the low calcium intake and eating disorder deteriorate the condition of the patient and increase the risk of the fast progress of osteoporosis. The patient should also refuse from alcohol and tobacco use. The patient should increase the intake of protein and calcium in her diet. Good sources of calcium are low-fat dairy products, dark green leafy vegetables, canned salmon or sardines with bones, soy products, such as tofu, calcium-fortified cereals and orange juice. She should also keep her body weight stable since low body weight increases the risk of osteoporosis and the patient face the risk of low body weight.

Conclusion

Thus, the patient has osteoporosis and the disease has progressed because the patient is in the high risk group. To put it more precisely, she is elderly since she is 65. She is female, while women are more vulnerable to the risk of the development of osteoporosis than men. She had menopause at the age of 42 that is earlier than the average age, when women have menopause. Menopause increases the risk of the development of osteoporosis because of the decrease of the bone weight. The patient also has symptoms of osteoporosis, such as back pain and her body frame also makes her susceptible to the risk of the development of osteoporosis. Finally, her T-score is below -2.5 that means that she has osteoporosis. Therefore, the patient needs the proper treatment which should include the medication along with changes in the lifestyle of the patient. In this regard, the patient may need to develop calcium rich diet and become aware of the risk of fracture which is high because of her fragile bones and osteoporosis.

References:

Akesson, K. (2003). New approaches to pharmacological treatment of osteoporosis, Bulletin of the World Health Organization, 81 (9), 657-663.

Cosman, F., et al. (2014). Clinician’s guide to prevention and treatment of osteoporosis, Osteoporosis International, 25(10), 2359-2581.

Reginster, J.Y., et al. (2006). Efficacy and tolerability of once-monthly oral ibandronate in postmenopausal osteoporosis: 2 year results from the MOBILE study. Ann Rheum Dis, 65(5), 654–661.

Sorensen, O.H., et al. (2003). Long-term efficacy of risedronate: a 5-year placebo-controlled clinical experience. Bone, 32(2), 120–126.

The terms offer and acceptance. (2016, May 17). Retrieved from

[Accessed: October 27, 2021]

"The terms offer and acceptance." freeessays.club, 17 May 2016.

[Accessed: October 27, 2021]

freeessays.club (2016) The terms offer and acceptance [Online].
Available at:

[Accessed: October 27, 2021]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: October 27, 2021]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: October 27, 2021]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: October 27, 2021]

"The terms offer and acceptance." freeessays.club, 17 May 2016

[Accessed: October 27, 2021]
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