Public Health Report by: Eric L. Zielinski
Not to be confused with osteopenia, a natural bone loss disorder that affects more than 50 percent of people older than 50 years of age, osteoporosis is a severe bone destruction condition that puts the elderly at a high risk of falls, fractures and various complications. As physicians are increasingly becoming hesitant to prescribe medications due to the severe side effects, the need for proven, alternative methods to help people with osteoporosis is in high demand. The purpose of this report, therefore, is to suggest that the ancient mind-body exercise Tai Chi may be able to answer that call as a budding selection of research supports its benefit to reverse bone loss.
Osteoporosis is a disease that causes bones to be so brittle and weak that mild stressors like coughing and falling could cause fractures According to the Mayo Clinic, “Bone is living tissue, which is constantly being absorbed and replaced.” Osteoporosis, therefore, occurs when the creation of new bone doesn’t keep up with the removal of old bone. Typically, there are no symptoms related to bone loss, however, the Mayo Clinic outlines some common issues that occur after bones have been weakened:
In general, osteoporosis is an age-related disorder. Since most people reach their peak bone mass in their early-to-mid-twenties, someone’s likelihood of be being affected by osteoporosis is greatly determined by the amount of bone mass developed during these formative years.
However, women are particularly at risk, especially when they experience early menopause. People with a history of long-standing corticosteroid use are also at high risk. Since everyone experiences loss of bone mass as they age, whether or not the bones become brittle is the concern.
The following risk factors are related to osteoporosis:
Research has found that one of the most beneficial activities someone can do to prevent and reverse osteoporosis is exercise. Weight-bearing, resistance training is particularly effective because it puts healthy stress on the bones and initiates the natural rebuilding/tear-down process and helps create healthy new bone formation. For people whose bone loss has markedly diminished, physicians will oftentimes prescribe medications to help stop the osteoporitic process.
According to the Mayo Clinic, “For both men and women, the most widely prescribed osteoporosis medications are bisphosphonates. Examples include:
The side effects of these drugs include significant gastrointestinal complains such as the following:
To address hormone imbalances, estrogen therapy is often employed soon after menopause as a preventative measure for women. However, this is widely known to significantly increase the risk of blood clots, breast cancer, endometrial cancer, and heart disease.
It is interesting to note that physicians will often prescribe antidepressant medications for elderly people who are depressed regardless if they have osteoporosis or not. The concern with this is that antidepressant medications can increase the risk of falls older people, especially if they have osteoporosis. Antidepressants have been shown to increase the risk of fragility fractures and data is lacking about the effect of fall rehabilitation programs on clinically significant depression.
According to Toronto researchers, “To date, there have been no recommendations for osteoporosis monitoring and treatment in individuals prescribed antidepressant medications, beyond the usual clinical guidelines. However, treatment of the older depressed person who is at risk of falls provides the opportunity to inquire about his or her adherence with osteoporosis and fracture prevention guidelines.” Therefore, to help prevent falls associated with osteoporosis, researchers recommend, “Based on the current state of knowledge, exercise (particularly Tai Chi) and cognitive-behavioral therapy should be considered for the first-line treatment of mild depression in older fallers.”
According to University of Maryland Medical Center the benefits of Tai Chi in regards to bone strength lies in its low impact component. “Low impact, weight bearing exercise strengthens bones and can slow bone loss, thus preventing the development of osteoporosis.” Although there are not many studies supporting this, U of M still recommends Tai Chi for people of all ages. A sample of the studies evaluating Tai Chi’s ability to help people with osteoporosis is outlined below:
It is interesting to note that the Tai Chi group maintained a higher rate of compliance than the resistance training group. The fact that older people are more likely to regularly practice Tai Chi should be considered when developing a care plan for osteoporosis patients.
Doctors from Queen’s Medical Center in Nottingham, UK sum it up perfectly. The evidence regarding the relationship between Tai Chi and physical, neurocognitive and psychosocial outcomes in older people “is an emerging and growing area of research and improvements have often been reported in health functioning, physical and emotional health, reducing falls, fear of falling and risk of falls, and possibly enhancing cardiovascular functioning in older adults although the effects on bone density, cognitive and immunological functioning are less clear.” There are many reasons to believe that Tai Chi can help reverse osteoporosis, however, until researchers spend more time on determining the exact nature in which people are benefited, physicians will be reluctant to include Tai Chi into their regular care plan for osteoporosis patients.
According to a 2012 article from Current Aging Science, “There are some indications that Tai Chi may have the potential to improve bone mineral density and reduce fracture rate particularly in frailer older adults, although more rigorously conducted research is required before satisfactory conclusions can be drawn.” Consequently, the medical community will remain hesitant to recommend Tai Chi to osteoporosis patients until more research confirms and re-confirms what people have known for thousands of years: Tai Chi does wonders for the body and osteoporosis is no exception!
Current Aging Science
BMC Complementary and Alternative Medicine
American Journal of Geriatric Psychiatry
American Journal of Chinese Medicine