AS SINGAPORE’s population ages, more people may suffer from osteoporosis.


From the late 1960s to the late 1990s, the rate of people aged 50 and above suffering from hip fractures has increased five-fold in women and 1.5-fold in men, according to the International Osteoporosis Foundation.


The number of hip fractures per year in Singapore is projected to increase from 1,300 in 1998 to 9,000 in 2050 because of the ageing population.


Dr Leslie Ng Chong Lich, consultant orthopaedic surgeon at Island Orthopaedic Consultants in Mount Alvernia Hospital, says osteoporosis can often cause fragility fractures in the elderly.


Says Dr Ng: “Osteoporosis usually presents itself as a bone fracture from a trivial, low-energy injury such as a simple fall.”


He adds that a spinal fracture may cause a humpback deformity of the spine, resulting in chronic back pain. In severe cases, it may cause nerve and spinal cord compression, leading to leg weakness and pain.


“Untreated hip fractures can lead to immobility and complications associated with prolonged bed rest, such as pressure sores and pneumonia,” he warns.


High-risk areas for fractures include the wrists, hips and spine.



Preventing accidents

There are precautions that family members can take if they have an elderly person in the family who suffers from osteoporosis.


Dr Ng advises: “Proper care for elderly people with osteoporosis should improve their quality of life and maintain mobility. Bones and muscles require exercise to maintain strength. Any exercise regime should be tailored according to the elderly person’s level of physical fitness.”


For instance, sustained weightbearing exercises such as brisk walking, taiji and qigong can help to improve balance, posture and coordination when performed under supervision.


For those with limited mobility, Dr Ng suggests taking appropriate safety measures. These include using walking sticks, wearing rubber-soled shoes and avoiding slippery floors.


Likewise, simple steps can be taken to reduce the probability of accidental falls occurring at home.


Dr Lim Yi-Jia, an orthopaedic surgeon at Gleneagles Hospital, recommends re-positioning key pieces of furniture so that the elderly have more space to move.


It is also best to avoid carpets at home, as the edges can trip up an elderly person and cause a fall, says Dr Lim.


Remove electrical cords and plant stands from commonly used areas at home.


Using a night light or glow-in- the-dark switches prevents unnecessary stumbling at night.



Just a phone call away

At Changi General Hospital (CGH), members of its Osteoporosis Liaison Service work to ensure that osteoporosis is diagnosed and treated for elderly patients with hip and spinal fractures.


Dr Linsey Utami Gani, a consultant from the endocrinology department at CGH, says: “We make it a point to inform patients of their treatment plans and improve their quality of care.


Hip-fracture patients who are eligible for the service are automatically signed up as part of their treatment pathway.”


CGH is the first hospital in Singapore to have a team of tele-carers who are dedicated to conducting follow-up work with osteoporosis patients. These tele-carers, who are trained nurses from the Eastern Health Alliance (EHA) Health Management Unit, regularly call patients to check on their progress.


Ms Cheryl Lee, a tele-carer with the Osteoporosis Liaison Service at EHA’s Health

Management Unit, says: “The frequency of our follow-up calls depends on the patient’s condition, such as whether they have undergone operations. Four to five calls may be made over 12 months, or more often if deemed necessary.”


The tele-carers look out for improvements, any signs or symptoms of wound infection, and ensure that patients take their medicine and attend their appointments regularly.


Any complications or problems are flagged to the Osteoporosis Liaison Service team, which then manages the patient’s condition


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