Osteoarthritis, osteoporosis and sarcopenia

• Articulating an equitable plan to tackle osteoarthrosis, osteoporosis and sarcopenia is a challenge for healthy and active ageing in Catalonia.
• OAFI (Osteoarthritis Foundation Internacional), founded in Barcelona in 2016 with the aim of leading the fight against osteoarthritis, will create a meeting place in the rectory of Sant Esteve de Llémena to raise awareness of a very prevalent and invisible pandemic disease.

Article by Marina Geli, Doctor and former Health Council published in Nació Digital

Life, on many occasions, creates unexpected meeting spaces. I live in Sant Gregori, a municipality close to Girona in one of the four that make up the Vall de Llémena. Sant Aniol de Finestres (Sant Esteve de Llémena It is a village in the municipality), Sant Martí de Llémena, Canet d’Adri and Sant Gregori (with seven municipalities) have created a community of municipalities to manage a territory of great landscape value, flora and fauna, cultural and gastronomic heritage. It is a sub-region between Gironès and La Garrotxa, around the Llémena river basin and the Transversal Range of Catalonia, with 185 km2. The Vall de Llémena is my geographical place of rooting, my life and my family, the grandparents who bought cattle, the veterinary father and the midwife and practitioner who arrived in all the country houses in very difficult years but with enthusiasm and professionalism.

Dr. Vergès, President of the OAFI, doctor of great national and international prestige, for those chances of life, he has a house in Sant Esteve de Llémena. The mayor of Sant Aniol de Finestres, Francesc Oliveras, with a clear political view, bought the Rectory attached to the church of Sant Esteve de Llémena, dating from 1623, and found with the Vergès and the OAFI, social use. We will collaborate in this project to remove from invisibility osteoporosis and sarcopenia and from the rigor of scientific evidence to provide guides of primary and secondary prevention, early diagnosis and treatments.

The privileged place and knowing that it gives life to a heritage of more than 400 years spurs us. The president of Girona FC, Delfí Geli, has been invited to participate to demonstrate the importance of preventing and adequately treating injuries in amateur or professional athletes. The differential gender perspective will be very present in the activities. Girls, girls, adult or older women have more osteoarthritis. The patient experience leads OAFI, an entity of affected people.

Osteoarthritis, osteoporosis and sarcopenia

Osteoarthritis (OA) is a chronic and degenerative inflammatory disease of the joints. It mainly affects the joints that hold more weight or are more used. Cartilage is a semitouous, avascular tissue made up of proteins, sugars and water, which covers the ends of the bones and is responsible for cushioning the blows and facilitating the movement of the joints. It is the most common rheumatic disease and, on the other hand, there is no awareness of disease but of irreversible process of aging. 595 million people affected in the world. More than 7 million in Spain.  More than 1 million in Catalonia. It affects 50% of people over 80 years of age.

23.5% of women over the age of 15. More than 60% have moderate or acute pain, 91% have an impact on their daily activities and 45% are not satisfied with treatments. It is one of the health challenges to be reviewed, since it implies a high demand, cost and loss of quality of life. The risk factors are age, female sex, genetics, trauma and/or fractures, overweight, obesity, menopause (three times the risk), professional sports activity or intense physical activity. The diagnosis is clinical and corroborated with medical imaging.

Osteoporosis is a skeleton disease caused by loss of bone mineral density. More than 500 million people affected in the world, more than 3 million in Spain, more than 300,000 in Catalonia. Osteoporosis increases the risk of fractures of wrist, hip, forearm, vertebrae with low impact traumas by four. Fragility fractures are a serious clinical complication of osteoporosis. Every minute, according to published studies, there is a fracture in Spain. The risk factors are age, female sex, menopause, genetics, lack of lime and vitamin D, sedentary lifestyle, certain diseases such as eating disorders, hyperthyroidism, inflammatory bowel diseases, rheumatoid arthritis and consumption of certain drugs, especially corticosteroids. Radiological diagnosis requires bone densitometry.

Sarcopenia is the loss of muscle mass that accelerates with age, menopause, obesity, coexisting in nutritional disorders, severe or chronic acute diseases incapacitating and in stays in intensive care units.  It increases the risk of falls, fragility, hospitalisations, immobility and is a prognostic factor of loss of autonomy and mortality.

Osteoarthritis, osteoporosis and sarcopenia, they have a great social, health and economic impact and there is no articulated and equitable plan. It affects all elderly people, many women, many amateur or professional athletes and obese people. There is more and more research in all areas every day. Patients and experts can contribute all the knowledge to develop effective value policies.

In Catalonia, it is a challenge for healthy and active ageing, for the necessary prevention of injuries at a positive time of increasing physical activity and sport and for improving the quality of life and years of autonomous life for people who will at the same time help the sustainability of the system.

The research indicates that adequate feeding, regular physical activity that allows cartilage care, maintaining bone mass and gaining muscle strength are the best prevention before osteoporosis and sarcopenia and also when there are diagnoses. Physical activity, sport, healthy eating and quality rest adapted to each person, to each stage of life from childhood, incorporating the differences of sex and physical constitution. Clear circuits of early and reliable diagnosis and proven indications of drugs, repairers or symptomatics and surgical indications must be made.

It requires interdisciplinary work between the different medical specialties (family doctors, rheumatologists, traumatologists, endocrinologists, pharmacologists specializing in pain…) professional physiotherapists in physical activity and sport, nutritionists, psychologists, nurses and always with patient experience.

Countries like Japan incorporate movement into everyday life throughout life, in the open air, at home, in the company: Taichi, Yoga, Pilates, meditation as cultural elements. They have more flexibility, less bone and muscle fragility, fewer fractures due to these techniques, and to have the habit of walking barefoot and sitting on the ground.

Dr. Vergès, with OAFI, leads the call to stop making arthrosis, sarcopenia and osteoporosis invisible. There is a long way to go, to improve the health of many people. The next 22 and 23 October Barcelona hosts the 9th Worls OA Congress organized by the International Foundation of Osteoarthritis with the participation of world experts and patients.

Article by Marina Geli, Doctor and former Health Council published in Nació Digital