Effects of Aging on Bones and the Available Solutions

BBones are the framework of your body. Bone has mechanical and homeostatic purposes, including walking and locomotion, protecting internal organs, weight-bearing, banking the marrow inside itself, and functioning as a calcium reserve.

The image of bones as a static “skeleton in the closet” has led to many misconceptions that they do not alter and stay the same once bones are formed. However, it is not the case. Aging is the natural process involving diminished bodily functions, and bone- aging is also one of the natural processes.

You may think of bone tissue as a bank account where you can make “deposits” and “withdrawals.”

The bones in our body are specially designed, and each bone, either small or large, has a purpose. They are very soft and fragile in childhood and gradually hardens and ossifies as time passes.

HOW DOES BONE AGE?

A bone is a living tissue that continually changes, eliminating old bone and replacing new bone.  It is a specialized process with complete regulation throughout your life between the Osteoblasts (the bone-forming cells) and Osteoclasts (the bone absorbing cells). In this, your body is in a constant state of bone turnover, as your old bone is replaced with a new bone. A procedure named Remodeling takes place. Your entire skeleton is replaced about every 10 years, though this process slows as you get older. Most bone is replaced until about age 40.

However, after the age of 40, less bone is rebuilt. The aging bone has reduced mineral content and get more prone to weakening and breakage. This is mainly due to low estrogen levels with advancing age. A stable estrogen level is essential for sustaining the regularity of bone remodeling. When estrogen levels fall, the messenger molecules that help maintain a healthy balance of bone formation and breakdown fluctuate. Without estrogen, osteoclasts become more active, and your body breaks down more bone.

When Does Bone Mass Peak?

Bone mass reaches its peak strength at age 30 in both women and men. For a period after attaining peak bone mass, your body restores roughly as much as it loses.

Reproduced from J Bernstein, ed: Musculoskeletal Medicine. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003.

In women, this process gets more frequent with the beginning of menopause. Learn more about changes occurring with menopause here.

Age-Related Effects on Bones:

Low bone mass indicates that bones are weaker, putting people at risk of fractures from a sudden bump or fall. Following changes can be marked with age. 

• OSTEOPOROSIS: It is a reduced bone mineral density produced by a change in bone microstructure, which eventually predisposes to fractures. It makes the bones thinner and weaker.
• OSTEOPENIA: is when your bones are weaker than normal but not so far gone that they break easily, which is the hallmark of osteoporosis.
• Overall height decreases, mainly because the trunk and spine shorten.

Age-Related Effects on Joints:

• Changes in cartilage and connective tissue influence people’s joints as they age—the cartilage inside a joint thins out, and the components of the cartilage change. As the cushioning cartilage begins to break down from a lifetime of use, joints become inflamed and arthritic. Thus less fluid does not slide as it used to do, leading to OSTEOARTHRITIS.
• Range of motion limits due to stiffness and pain.

Why it matters?

• 29% of premature mortality due to nonhip and nonvertebral fractures (50% of all fractures in the study)
• Suffering due to fractures
  • Approximately 40 in 100 women will experience one or more fractures after the age of 50 years.
  • An osteoporotic fracture happens every 3 seconds. It affects 200 million women worldwide – approximately.
    • 1/10 of women aged 60,
    • 1/5 of women aged 70,
    • 2/5 of women aged 80 and
    • 2/3 of women aged 90.

Factors Affecting Bone Loss:

• Both sexes experience a continual and gradual process of bone loss as they age.
• Genetic factors.
• Hormone deficiency.
• Smoking.
• Alcohol has an inhibitory effect on osteoblastic activity.
• Obesity or being overweight.
• Systemic illness: 
• Rheumatoid arthritis and prolonged use of corticosteroids accelerated bone loss.
• Gastrointestinal disorders causing malabsorption.
• Drugs such as anticonvulsants.
• Chronic renal disease and Amenorrhoea.

How to Check Your Bone Density?

As we know that over time, our bones get weakened. So how to measure the weakening bone? There are certain tests known as BMD (Bone mineral density).  People above and equal to the age of 65 years are advised to go for this test. The findings may aid your doctor in determining how to treat or prevent bone loss and fractures.

There are two types of tests;

• DXA (dual-energy X-ray absorptiometry) measures the density via the hip, spine, or total body. It’s more reliable. Normal bone density is defined as a T-score of -1.0 or higher. Your bones are weaker if you get a low score:
• Low bone density, or osteopenia, is indicated by a T-score of -1.0 to -2.5.
• Osteoporosis is defined as a T-score of -2.5 or lower.
• QCT (quantitative computed tomography): Measures via the spine. It is less reliable.
• There are many other methods to measure via the wrist, heel. There are called pDXA, QUS, and pQCT.

BONE ANTI-AGING – REVERSING THE CLOCK!

Aging is inescapable; however, not all difficulties linked to age can be neglected. Certain methods help to slow down the bone-aging process and also make bones strong!

Exercises

One of the many benefits of doing exercise is that it helps to maintain bone health. You can retain strength, balance, and flexibility by a moderate exercising regimen. Physical activity in later life can help halt the progression of osteoporosis by slowing the loss of bone mineral density. There is a study that suggested that doing a moderate level of exercise helps to maintain bone health. Do a 30-minute session or smaller session of walk or any moderate level strength training exercises—two to three days per week. If you don’t have much time for strengthening/resistance training, do small amounts at a time.

Warm-up before you exercise and cool down afterward. By simply taking regular brisk walks, you can improve your bone density and reduce your risk of hip fractures. Don’t forget to consult your doctor before starting any exercise program! 

Exercise helps the bones stay strong.

Types of Exercises: 

1. Walking. According to WebMD, “a study of nurses found that walking four hours a week offered them a 41% decreased risk of hip fractures, compared to walking less than an hour a week.”
2. Resistance training: Weight-bearing, body-weight resistance, or weight-training machines.
3. Using free weights:  such as dumbbells and barbells, elastic band resistance.
4. Aerobics exercise: like jumping, dancing low impact cardio.
5. Tai Chi: to improve posture, balance, and prevention of falls.
6. Swimming and water exercise (such as aqua aerobics or hydrotherapy).

Check out the types of exercise to do for your age and what each workout is meant to support one’s health here.

Diet

A proper and healthy diet can help you manage osteoporosis or even delay it.  Many foods options are enriched with calcium, Vitamin D, and magnesium. NHS suggests few food options:

1. Dairy products: Milk, cheese, yogurt, and butter, etc.
2. Green leafy vegetables, broccoli, okra but not spinach.
3. Fortified flour-based products.
4. Fish.
5. Dried fruits and nuts.
6. Tofu. (Half a cup of calcium-enriched tofu contains more than 860 milligrams of calcium)
7. Figs (contains Calcium and magnesium).
8. Sweet potatoes (Magnesium and Potassium).

Although spinach contains a lot of calcium, it also contains oxalate, which reduces calcium absorption, and it is not a good source of calcium.

Check out this article on what you eat affects how you are.

Vitamin D

Women, in particular, must be cautious about getting enough calcium and vitamin D as they grow older.

Adults (19-70 years) need 15 micrograms (600 International Units or IU) of vitamin D a day.

Calcium intake for postmenopausal women and males over the age of 70 should be 1,200 mg per day.

Vitamin D should be consumed in 800 international units (IU) per day by women and males over 70. Consult your doctor about prescription medications if you have osteoporosis.

Maintain Your Weight

The key is to maintain healthy body weight. Carrying too much weight puts undue strain on the joints, increasing wear and tear and increasing the incidence of osteoarthritis. For further assistance on how to maintain body weight, read out this article.

Avoid Smoking

Smoking makes you more susceptible to osteoporosis and bone fractures and makes musculoskeletal injuries heal more slowly. After the age of 30, smoking accelerates the loss of bone mass by 1.5 to 2 times. The hip, spine, and wrist areas of the body that lose the most bone mass. So it’s advisable to avoid smoking or reduce it to the maximum.

Reduce Alcohol

Excessive alcohol use disrupts the calcium balance, which is necessary for healthy bones. Alcohol’s tendency to interfere with the formation of vitamin D, a vitamin required for calcium absorption, may further impair calcium balance. Limiting the intake at even early age helps to prevent bone loss.

A study published in  Alcoholism, Clinical, and Experimental Research, discovered that light-to-moderate drinking (3-4 glasses/week) might benefit elderly individuals by delaying bone remodeling. However, its influence on the skeleton and bone remodeling of younger individuals is less certain.

Avoid Certain Medications (if possible) and Keep a Habit of Medical Checkups

Ask your doctor whether medication may be affecting your skeleton. Several drugs contribute to bone loss, including some long-term anti-seizure drugs, certain cancer treatments, and glucocorticoids, which are used to treat many diseases, such as asthma, and Crohn’s Disease.