Osteoporosis, a condition when bone becomes porous and fragile, leads to 8.9 million fractures per year around the globe. Like the bones hidden inside the body, osteoporosis is hidden and silent. Often, there is no symptom until a fracture occurs. Despite the substantial number of fractures, awareness and screening to prevent such disability are not properly emphasised.
One in three women and one in eight men aged 50 and older are suffering from osteoporosis and its devastating consequence — fracture. The most common osteoporotic fractures are of the vertebrae and the hip that leads you unable to stand. Hip fractures are the most serious and costly. One-half of patients become permanently disabled and 20 to 25 percent require long-term care. Ninety percent of hip fractures in women and 80 percent in men are attributable to osteoporosis.
Non-modifiable risk factors for developing osteoporosis include advanced age, female sex (especially post menopausal women), family history, caucasian race, premature menopause (below 45 years) and previous fragility fracture.
Modifiable risk factors include physical inactivity, cigarette smoking, excessive alcohol intake, low body weight, low calcium intake, prolonged immobilisation and taking steroid glucocorticoids.
In order to prevent or stop osteoporosis, we can manage modifiable risk factors those we can control. Specially, we should take adequate calcium (at least 1200 mg/day) from calcium rich foods like milk, cheese, spinach, collard green, beans, broccoli, peas etc. Vitamin D, physical exercise and quitting smoking can also make a big difference in preventing osteoporosis.
People with non-modifiable risk factors should consult with specialised doctors to explore whether they need screening or not. A patient should be evaluated for fracture risk by a physician and drugs are prescribed according to need. The drugs used in treatment appear to reduce some fractures by 25 to 50 percent.
While older suffer the consequences of osteoporosis, this disease begins early in life. A healthy lifestyle in childhood, adolescence and early life can preserve the optimum bone mass to prevent the disease. We should bring the silent epidemic under proper projection of light with adequate awareness to help ourselves and consecutive generations to stand with strength.

The writer is the Chairman, Department of Medicine, BSMMU and also the Vice-President of Asia Pacific League of Associations for Rheumatology (APLAR).