3 out of 5 Mumbai Women Suffer from Brittle Bones: Nanavati Max Hospital study

Mumbai, March 10: Three out of five women of Mumbai, over the age of 40 years, suffer from Osteopenia and one in four are diagnosed with Osteoporosis, discovered a study conducted by Nanavati Max Super Speciality Hospital on International Women’s Day. 

Age, Vitamin D deficiency, menopause, chronic diabetes or kidney diseases, lack of physical exercise and sedentary habits are the precipitating factors for Osteoporosis and Osteopenia. 

Dr. Gayatri Deshpande, Senior Consultant and Dr. Janvi Lalchandani, Assistant Medical Officer from Department of Obstetrics and Gynaecology, Nanavati Max Super Speciality Hospital screened over 5,034 patients’ data during a period of 18 months, from September 2021 to February 2023. 

To avoid clinical bias, the researchers excluded high risk groups such as women with a previous diagnosis of osteoporosis or osteopenia, current or past history of cancer, fractures and only considered women over the age of 40. Four major sites of bone degeneration – lumbar region, femoral neck, 1/3 femur, and total body – were considered to determine the prevalence of these conditions.

After excluding high risk groups, the study analysed data of 1921 women, aged between 40-95 years, who underwent Dual-Energy X-ray Absorptiometry (DEXA) scan which measures the bone mass density. 

Osteoporosis and osteopenia are conditions characterised by low bone density, which can increase the risk of fractures, chronic pains, and loss of mobility. In osteoporosis, bones become weak and brittle, making them more likely to break. Osteopenia is a milder form of bone loss that can progress to osteoporosis if left untreated. These conditions are common in women of peri and postmenopausal age group. 

Surprisingly so, of the 1,921 women studied, 519 or 27% had osteoporosis, while 1222 or 64% had osteopenia. The prevalence of osteoporosis and osteopenia increased with age, with almost half the women (48%) in the age group of 61-80 developing osteopenia of the femoral neck—part of the thigh bone that connects to the hip joint. Osteopenia of the femoral neck multiplies the risk of hip fractures and cause loss of mobility, balance, significant disability, reduced quality of life, and even mortality in some cases. Osteopenia of the femoral neck can also impact mobility, balance, and overall physical function, which can further affect a person’s independence and well-being. 

One out of five participants were diagnosed with osteoporosis in the lumbar region, increasing the risks of compression fractures of the vertebrae and spinal deformity, such as dowager’s hump, which can affect breathing and increase the risk of falls. 

Dr Deepak Patkar, Head, Imaging and Director (Medical Services), whose team performed the DEXA scans, said the higher number of post-menopausal women complaining of severe backache and joint pain, prompted the clinicians to analyse the BMD data of women who undergo regular health check-up. “Steroids use or abuse, chronic smoking and alcohol consumption and eating disorders such as anorexia nervosa or bulimia nervosa, most commonly cause bone degeneration in teen and younger women. Moreover, Estrogen—responsible to improve bone health and reduce calcium degeneration from the bones, depletes drastically after menopause. This increases the chances of bone decay in older women,” he said, while discussing the objectives and risk factors of the study. 

Started as a retrospective study, it will continue as a prospective study until 2025. “The results have been quite surprising and its alarming to know very few women are aware of this,” Dr Deshpande added. 

The study’s results highlight the importance of targeted screening and prevention strategies. While osteopenia can be maintained, osteoporosis cannot be reversed. Thus, routine check-ups, including bone density scans specifically performed using DEXA technology is recommended for women over the age of 30 every five years.

“Women, on daily basis, suffer in silence during simple tasks such as kneading the dough, twisting a doorknob, car steering or even walking on slippery floor or sandy beach. Bone fractures caused by these conditions can result in hospitalization, surgery, and long-term disability. Studies such as these will help us prevent these conditions in future,” said Dr Deshpande. 

Regular check-ups are also crucial in maintaining good bone health. During check-ups, doctors can evaluate the risk of osteoporosis and other bone-related diseases by assessing the patient’s medical history, lifestyle factors, and family history. Based on the evaluation, doctors can recommend preventive measures, such as calcium and vitamin D supplements, weight-bearing exercises, and medications.