Describe what places a person at risk for the development of osteoporosis and discuss some interventions to prevent the development or progression of osteoporosis?

Part A Primary osteoporosis is linked to ageing and decline in sex hormones causing decrease in bone mineral density. Secondary osteoporosis affects mostly men and is caused by other disorders or the therapies including glucocorticoids and anti-epileptics. Chemotherapy drugs, thiazolidines, and proton pump inhibitors have also been linked to osteoporosis. Hyperparathyroidism, hyperthyroidism, malabsorption, anorexia, chronic kidney failure, Cushing, and conditions causing long-term immobilization are potential risk factors (Varacallo & Fox, 2014). Other factors include age, female gender, high BMI, smoking, alcohol consumption, history of familial bone fractures, pre-menopause, reduced or strenuous physical activity, Caucasian or Asian ethnicity, history of fractures after 40 years, secondary amenorrhea for > 1 year due to low body weight (under 128 pounds), or hormone therapy without estrogen (Greenstein & Gorczyca, 2019) Part B Treatment length varies with medication. Unless teriparatide or hormone therapy is rapidly replaced, substantial bone loss ensues. Clinicians should avoid using bisphosphonates for more than 3-5 years. Patients should be warned about these potentially deadly side effects and told to seek emergency care if they develop thigh pain. Patients on bisphosphonate with mild thigh pain should stop using bisphosphonates, all weight-bearing activities and get hip and femur X-rays. Thigh pain could signify a rare but possibly catastrophic atypical femur fracture. A specialist may be consulted about preventative orthopedic surgery (Varacallo & Fox, 2014; Jiang et al., 2019; Larsen & Schmal, 2018). Reference Greenstein, A. S., & Gorczyca, J. T. (2019). Orthopedic Surgery and the Geriatric Patient. Clinics in geriatric medicine, 35(1), 65–92. https://doi.org/10.1016/j.cger.2018.08.007 Jiang, S. Y., Kaufman, D. J., Chien, B. Y., Longoria, M., Shachter, R., & Bishop, J. A. (2019). Prophylactic Fixation Can Be Cost-effective in Preventing a Contralateral Bisphosphonate-associated Femur Fracture. Clinical orthopaedics and related research, 477(3), 480–490. https://doi.org/10.1097/CORR.0000000000000545 Larsen, M. S., & Schmal, H. (2018). The enigma of atypical femoral fractures: A summary of current knowledge. EFORT open reviews, 3(9), 494–500. https://doi.org/10.1302/2058-5241.3.170070 Varacallo, M. A., & Fox, E. J. (2014). Osteoporosis and its complications. The Medical clinics of North America, 98(4), 817–xiii. https://doi.org/10.1016/j.mcna.2014.03.007