To prevent fractures (broken bones), attention must be paid to reducing individual risk factors.
Behavioral risk factors
- Diet
- Alimentary osteopathy (nutritional bone disease/ starvation osteopathy due to malnutrition (calcium, calciferol and protein deficiency).
- Micronutrient deficiency (vital substances) – see prevention with micronutrients.
- Consumption of stimulants
- Alcohol
- Tobacco (smoking) – Smoking leads to accelerated osteoporosis and increased fracture risk.
- Physical activity
- Physical inactivity – Physical activity promotes bone stability, immobilization leads to osteopenia (reduction in bone density; precursor to osteoporosis).
- Overweight (BMI ≥ 25) – obesity promotes degenerative bone and joint disease.
Medication
- Medications that promote osteoporosis (see under “Osteoporosis due to medications”).
- Antidepressants (amitriptyline, imipramine) have an increased risk of hip fracture in elderly patients
- Glitazones – group of oral antidiabetic drugs that have been found to increase fracture risk in women and have been withdrawn from the market because of this.
- Proton pump inhibitors (PPIs; acid blockers) – increased risk (five outcomes per 10,000 patient-years) of proximal femur (hip) fracture after long-term use.
Preventive measures (protective measures)
- General accident prevention
- Physical and mental training, mobility
- In sports appropriate protective clothing (eg wrist protection when inline skating).
- Osteoporosis prophylaxis:
- Promote muscle strength and coordination and avoid immobilization.
- Take a fall history annually from the age of 70.
- Fracture prophylaxis (bisphosphonates and denosumab reduce fracture risk for vertebral and nonvertebral osteoporotic fractures; raloxifene reduces risk for vertebral osteoporotic fractures)Caution: osteonecrosis of the jawbone and external auditory canal during therapy with bisphosphonates and denosumab.
- Weather adapted footwear, walking aids if necessary.
- Age-appropriate home furnishings
- Therapy of fall-causing diseases
