The Silent Epidemic Nobody Is Talking About
Every year, patients walk into orthopaedic clinics after a low-energy fall/ a simple fall, a misstep on the stairs and only then discover that their bones have been fractured. Osteoporosis and sarcopenia are not over the night diseases. They announce themselves quietly, and by the time they do, significant damage has already been made.
Osteoporosis reduces bone mineral density, increasing fracture risk at the hip, spine, and wrist. But the true burden is what follows : prolonged immobility, surgical risk in elderly patients, and a one-year mortality after hip fracture that rivals many cancers. It is not just a metabolic condition. It is a surgical crisis waiting to happen.
Sarcopenia acts just as an unwanted addition with compounding action. Progressive loss of skeletal muscle mass and function accelerates after the fourth decade, impairing balance, gait, and the ability to recover from injury or surgery. In spine surgery particularly, low muscle mass measurable on routine MRI as the psoas muscle index is emerging as a powerful predictor of poor outcomes.
Together, these conditions form a silent epidemic affecting the geriatric population.
The tools exist to screen and diagnose; DEXA scans, validated frailty scores, and nutritional assessments are accessible. Resistance training, protein optimisation, vitamin D supplementation, and pharmacotherapy when indicated can genuinely help and prevent the morbidity.
But are we ready to accept the existence of this age related epidemic and get diagnosed early ?
MBH/PS