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Osteoporosis in Young Women

Osteoporosis in young women results from a drop in estrogen levels in the body, which leads to bone frailty as estrogen works to protect the bones (Popat et al., 2009). A poor diet with inadequate vitamin D and Calcium leads to osteoporosis as the body usually breaks down the bones to get the calcium it requires (Rubin & Reisner, 2009). It may also result from various medical conditions, such as cancer, emphysema multiple sclerosis, asthma, lupus and rheumatoid arthritis, and the medications that treat them as they affect the bone strength (Allport, 2008). Lifestyle choices such as inadequate diet, heavy alcohol consumption, lack of weight-bearing exercise can rob the bones of their strength (Bhalla, 2010).  

Epidemiology

Osteoporosis is a very common metabolic disease, which affects over 10 million Americans (National Osteoporosis Foundation, 2010). It leads to 1.3M to 1.5M fractures every year including “700,000 fractures, 300,000 hip fractures, 250,000 wrist fractures, and more than 300,000 fractures in other regions” (Bohaty et al., 2008). Of the estimated population with osteoporosis, almost 80 percent or eight million are women (National Osteoporosis Foundation, 2012). The incidence of vertebral fractures resulting from osteoporosis in younger patients (<35 years) is estimated to be three per 100,000 ever year and rises to 21 in the population range of 35-44 years. This is associated with decreased bone mass in young persons’ especially women (Melania, Dolors & Susana, 2011). Osteoporosis is more common in Asian and Caucasian women. According to the National Osteoporosis Foundation (2010, p. 3), “About one out of every two Caucasian women will experience an osteoporosis-related fracture at some point in her lifetime.” The lifetime risk of any spine, hip or distal forearm fracture is almost 40% in white women (Melton et al., 2009).

 

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Asian and Caucasian women face a greater risk of suffering from osteoporosis than White and Black women do. Barrett-Connor, Siris & Wehren (2005) conducted an analysis to determine osteoporosis in women of different ethnic groups. The analysis consisted of 1708 Native American women, 6973 Hispanic, 1912 Asian, 7784 black, and 179, 470 white women. The odds for osteoporosis were 1.05 for Asian women, 1.20 for Hispanic women, 0.96 for Native American women and 0.55 for black women. Black women had the highest bone mass density whereas Asian women had the least and hence were at more risk for developing osteoporosis. The researchers found osteoporosis in 4.2% blacks, 7.2% whites, 9.8% Hispanics, 10% Asians, and 11.9% Native Americans.

Pathophysiology

Osteoporosis results from structural weakening of bone tissues as well as reduced bone mass, which cause fragility of the bone as well as raised vulnerability to fractures, particularly of the wrist, spine, as well as of the hip (Wolfgang, Pietschmann & Rauner, 2008). The fragile nature of the bones is a composite of low mass density, geometry, altered bone material quality, and disconnection of the micro architectural connection in trabecular structures (Bartl & Frisch, 2009). Reduced bone mass results from inadequate intakes of vitamin D and calcium, gonadal hormonal deficiency, drug effects while treating unrelated medical conditions, deficiency of gonadal hormone and decreased physical activity (Ferrari, Bianchi & Eisman, 2012). As a result, preventive programs have to address most of these factors. Restoring body weight is also a key treatment and supplementation of Vitamin D if low (Teng, 2011).

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Risk Factors

Constitutional or genetic factors are among the risk factors of osteoporosis (Stetzer, 2011). Young women whose families have osteoporosis of fractures history are usually at a significant risk of developing the disease. It has been established that women with such a background are more prone to such fractures relative to those without. The second factor is rate; young women who are Asian or white are usually at a greater risk than Hispanic and black Americans (Melton, Chrischilles & Cooper, 2008). Smaller body sizes or physical frailty also predisposes the young women to increased risk of osteoporosis. Certain medical condition and their medications also contribute to an increased risk as they lead to reduced bone mass (Fatima et al., 2009). Eating disorders such as bulimia or anorexia nervosa, cigarette smoking, inadequate calcium consumption, inactive lifestyle, heavy alcohol consumption are also risk factors (Garrison, 2012).

Complications of Osteoporosis

The most serious complications of osteoporosis are bone fractures, especially in the hip or spine because of the loss of bone density and strength (Cauley, 2011). Spinal fractures even occur when one has not fallen whereas some fractures result from a minor injury. The bones that make up the spine weaken to the point that the person can crumple, lose height, experience back pains and have a hunched forward posture (Yu & Finkelstein, 2012). Sometimes the fractures occur while performing routine daily activities. Hip fractures put patients at a risk of orthopedic complications and require surgery associated with the condition. Patients are also susceptible to pulmonary embolism, deep vein thrombosis, and pneumonia and immobility issue. Osteoporosis also lead to Kyphosis, a serious complication which vertebral fractures lead to spinal deformity and also breathing difficulties as internal organs get compressed (Olga, 2011).

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Nutrition

Foods rich in Vitamin D and Calcium are important in preventing and treating osteoporosis (National Institution of Health, 2009). Calcium plays an important role in building the bones whereas Vitamin D allows the bones to absorb calcium. Most food contain calcium, however the most easily absorbed and richest source are dairy products such a cheese, yoghurt or milk (McGuire & Beerman, 2013). Foods such as cereals, pulses, seeds, nuts, green vegetables, and dried fruits also contain calcium. Vitamin D facilitates absorption of calcium in the digestive system and most of it comes from exposing the skin to sunlight. It is also found in certain foods such as oily fish (Edelstein, 2011). Fruits and vegetables also help to build healthy bones and to maintain calcium in them. Consumption of these foods helps to build healthy and strong bones hence protecting them from loss of density and strength (Edelstein, 2011).

Physical Activity

According to Weeks, Young and Beck (2008), physical activity is important in avoidance as well as curing osteoporosis as they increase the strength of the bones. Physical inactivity diminishes bone mass. For the exercises to be beneficial, especially for long term, they need to be performed in moderation and regularly for at least 30 minutes every day (Varner, 2012). In addition, weight-bearing activities like resistance exercise, jogging and walking build muscle strength and enhance the patient body awareness and balance hence cutting the risk of falling (Nikander et al., 2010; Olga, 2011).

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PowerPoint Presentations

PowerPoint Presentations play an important role in delivering the material on osteoporosis as they provide a means of a great presentation, which makes learning interesting (Wright, 2009). PowerPoint presentations combine words with visual and sound features, which enable them to communicate information across the board and to the young women, informing them about the causes, risk factors, complications, and preventive measures of osteoporosis. Inclusion of clip arts images, assorted charts, as well as additional graphical elements make the presentation eye catching whereas the sound effects and animation put in more emphasis on the presentation making it further interactive to the audience (Krish, 2008). The presentations enhance the learning experience for the audience making it easier for them to grasp the content being presented (Reynolds, 2012).

Learning Theory

The most appropriate learning theory to deliver Osteoporosis information is cognitive learning theory; according to this theory, for a person to learn, his or her cognition has to be changed (Schunk, 2008). Cognition included the person’s memory, thought, perception, processing, and organization of information (Chapman & Fratiani, 2008). During learning, the person receives the information, interprets it based on past learning and organizes it into new understanding. Motivations towards learning, including the learner’s goals, are important (Bastable, 2008). Getting the young women’s behavior to change towards actions that prevent them from acquiring the disease is largely a matter of cognitive learning in order to strengthening the required practices to avoid getting osteoporosis.

 

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