According to consultant geriatrician Dr Edward Chong, most patients discover the condition after a fragility fracture – a break caused by a minor fall or low-impact injury that wouldn’t normally harm healthy bones.
“Osteoporosis does not cause pain or clear warning signs until it is too late. Most patients are diagnosed only after experiencing a fragility fracture. By then, the disease has already caused significant damage,” he said.
Fragility fractures commonly affect the hip, spine, and wrist, each carrying serious consequences. “Hip fractures are the most severe as they often result in prolonged loss of mobility. Based on global data, one in four patients is at risk of dying within a year due to complications,” Chong noted.
Osteoporosis also has emotional effects, with many patients developing a fear of falling that can limit movement, weaken muscles, and lead to social isolation.
The condition’s rising incidence in Malaysia is linked to dietary and lifestyle factors, including low calcium intake and vitamin D deficiency.
“Despite Malaysia’s tropical climate, many people avoid sun exposure. Vitamin D is crucial for calcium absorption and bone health,” he said, pointing out that women are at higher risk after menopause but men are also affected.
“Screening using a dual-energy X-ray absorptiometry (DEXA) scan is the standard, simple and non-invasive test to measure bone mineral density. This scan helps detect thinning bones early, allowing treatment to begin before serious fractures occur.”
The Malaysian Clinical Practice Guidelines 2022 recommend DEXA scans for women aged 50 and above, men aged 70 and above, and anyone who experiences a low-trauma fracture. “Early assessment allows treatment to begin before serious fractures occur,” Chong stressed.
Treatment combines proper nutrition, physical activity, and medication depending on severity. “We recommend about 1,000mg of calcium and 800 IU of vitamin D daily, alongside exercises such as walking, light weight training, and tai chi to improve bone strength and balance,” he added.
Chong also emphasised the role of family in prevention, from creating a safe home environment to encouraging older adults to stay active.
“Osteoporosis prevention begins at a young age. Strong bones are built over a lifetime and form the foundation for independence and mobility in later years,” he concluded.