As we “have more birthdays” as Dr. Susan Behnawa, our geriatrician, so delicately puts it, we need to consider the best forms of preventative medicine to maintain our health and ultimately extend our lives. There are well-known screenings that are invaluable in preventative health, colonoscopies and breast cancer screenings, but one of the most forgotten topics is a bone health screening. Your bones are constantly being broken down and built back up by osteoclasts and osteoblasts. As you age, there can tend to be an imbalance and your body cannot keep up building back the bone at the same rate as your body is breaking it down leading to osteoporosis. Physicians will suggest a bone density scan (also called a DEXA scan) for their 65+ patients to evaluate and then treat any prospective issues.
What is a Dexa scan? The DEXA scan is a more sophisticated x-ray that takes the density of your bones in your lower spine and hip. When interpreting the scores, physicians will look at where you fall on the scale as compared to average.
When bone is less dense than the average, the t-score will be a negative value. Depending on the t-score, your physician will determine if you are osteoporotic or if you are in the stage right before that, called osteopenia. If you are not quite yet osteoporotic, physicians will then determine your FRAX score.
What is a FRAX score? A FRAX score estimates the possibility of a fracture within the next 10 years. The physician looks at the DEXA scan and checks if you have had a fracture at any point in time to determine this score.
If you are osteopenic with a higher FRAX score, you will be considered as an osteoporosis patient. Depending on your body and needs, your physician will prescribe vitamin supplements, medicine, or even physical therapy. Talk with your doctor if you are concerned about your bone health and want to take the preventative measures to maintain your health.
At Rancho Family, we focus the most on preventative medicine. Our practicing physicians, especially our geriatrician, Dr. Behnawa, want to ensure that you are doing everything you can prior to being fully osteoporotic. One of these preventative measures includes taking supplements to add nutrients that support bone health. The “big three” key nutrients that play a factor in bone health are Calcium, Vitamin D, and Magnesium. You may be surprised to know that many of us are deficient in these nutrients!
1 – Calcium can be found predominantly in dairy products, so if you are abstaining from dairy, you may be lacking in Calcium. Leafy greens can contribute to calcium in your diet but adding in chewable vitamins can also aid in needed daily intake.
2 – Vitamin D is found in some foods like salmon and egg yolks, but the sun is predominantly where humans get their Vitamin D needs. However, even in sunny Southern California, we are finding that people are still vitamin D deficient. The best option for Vitamin D supplementation is to visit your local health food store or purchase a Vitamin D supplement online.
3 – Magnesium is also vital for bone and muscle health. Magnesium rich foods include nuts, seeds and beans. Magnesium supplements come in many forms, but the form that is most predominantly used for bone health and that is best absorbed by the body is magnesium glycinate or chelated magnesium.
Before you purchase any supplements, please consult your doctor to see what your individual vitamin needs are so that they can partner with you to better your health. Taking these supplements and ensuring you have enough of these essential vitamins in your body is the first step to ensuring bone health. If you are, however, already osteoporotic taking these supplements may only be the beginning of your journey to better bone health.
One of the most important things you can do as you get older is lift weights or do strength training, both of which stimulate bone regeneration and keep the body strong. Keeping the bones strong is vital to reduce the risk of a fragility fracture, which is a small break in a bone from a lower velocity trauma. An example of lower velocity trauma could be tripping and trying to catch your fall on your wrist, resulting in a fracture. As you age, hip fractures can be one of the most common, having a 30% mortality rate due to complications.
Strength training does not have to mean benching 200+ pounds in your 60’s. There are manageable weight exercises that you can do at the gym or at home to strengthen bone density. Check out our CrossFit classes and our Senior Center classes if you are interested in maintaining and gaining strength. Our instructors meet you at your level and build from there.
If you have osteopenia or osteoporosis, physical therapy is an option to help strengthen your body! The best practice would be to get a referral from your primary care physician to get this treatment.
When you see a physical therapist, they will provide a rehabilitation plan tailored specifically to your needs. This can include weight-bearing exercise and balance exercises. They are also able to do a balance and gait assessment to ascertain if you are need of an ambulatory device. If you have the wrong type of ambulatory device, it can actually do you more harm than good. For example, if you borrowed a cane from a neighbor and the cane was built for pain management, it will not be the best tool for you to use to maintain your balance. Another example would be picking out the walker that seems like the best fit for you, like a rollator walker. If you do not have the proper balance for this type of walker, it can actually predispose you to injury.
When you see a physical therapist, they will work with you on your therapy plan and if necessary, suggest an ambulatory device best suited for your needs.
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