The Silent Thief of Strength: Why Malaysians Should Take Osteoporosis Seriously
by Dr Edward Chong Kah Chun
A simple stretch. A slight stumble. And suddenly, a bone fracture. Often called the “silent disease”, osteoporosis quietly weakens the bones over time, showing no signs until a break occurs, often from seemingly harmless fall.
“Osteoporosis doesn’t cause pain or visible warning signs until it’s too late. Most people are diagnosed only after they’ve had a fragility fracture, a break caused by a minor fall or impact that wouldn’t normally injure healthy bone. By that time, the disease has already done its damage,” explains Dr Edward Chong Kah Chun, Consultant Geriatrician at Sunway Medical Centre, Sunway City (SMC).
When a Minor Fall Becomes a Big Problem
According to Dr Edward, the most common osteoporosis-related or “fragility” fractures occur in the hip, spine, and wrist, each with serious consequences.
“Hip fractures are the most severe because they often lead to prolonged immobility,” he explains. “Globally, one in four patients may not survive the first year after a hip fracture due to complications.”
Spinal fractures, on the other hand, can cause persistent back pain and nerve irritation, sometimes even from something as minor as sitting down too quickly. Wrist fractures, while less life-threatening, can make daily tasks such as walking, dressing, or bathing difficult, especially if the dominant hand is affected.
Beyond physical pain, osteoporosis can also take an emotional toll. “Many patients develop what we call the ‘fear of falling’. They lose confidence in walking or leaving the house, which leads to muscle weakness and isolation. It becomes a vicious cycle: the less they move, the weaker they get,” says Dr Edward.
Why Malaysians Are at Risk
Osteoporosis is on the rise in Malaysia, driven by diet and lifestyle changes. “Our local diet is rich and delicious, but not always balanced,” says Dr Edward. “Many people don’t consume enough calcium-rich foods like milk, cheese, yogurt, tofu, or green leafy vegetables. Vitamin D deficiency is also common because we avoid the sun despite Malaysia’s tropical climate.”
Limited sun exposure means less vitamin D, which is vital for calcium absorption. Although foods like salmon, tuna, anchovies, and mushrooms can help, but daily morning sunlight remains the best natural source.
Women face a higher risk after menopause as oestrogen levels drop. “But men can also develop osteoporosis, especially if they have poor diets, smoke, or take certain medications for long periods,” Dr Edward adds.
When and How to Screen for Osteoporosis
Dr Edward refers to Malaysia’s Clinical Practice Guidelines on the Management of Osteoporosis 2022, which recommend screening in several situations.
“Anyone who has suffered a low-trauma fracture such as fall from standing height, should be screened immediately. Screening is also advised for women above 50 and men above 70, even if they appear healthy,” he advises.
The standard test is a DEXA (dual-energy X-ray absorptiometry) scan, which is a simple, non-invasive test that measures bone mineral density. “You can get it at most hospitals and some specialist clinics. We encourage early assessment because it allows us to act before a serious fracture happens, improving patient safety, quality of care, and long-term recovery,” says Dr Edward.
Stronger Bones Start with Daily Choices
Treatment for osteoporosis usually combines lifestyle adjustments with medication.
“Nutrition is the foundation. We encourage patients to consume around 1,000 mg of calcium and 800 IU of vitamin D daily. If diet alone isn’t enough, supplements may be prescribed,” Dr Edward explains.
Equally important is regular physical activity. “We need regular weight-bearing exercises, walking, jogging, or light resistance exercises to stimulate bone growth. Tai Chi is another good option as it helps improve balance and prevent falls,” Dr Edward adds.
For patients with severe bone loss, oral medications are commonly used to strengthen bones. Injectable or infusion treatments are available for more advanced cases and can be administered monthly or yearly depending on the patient’s condition. “These therapies are highly effective when combined with proper follow-up and lifestyle care,” says Dr Edward.
How Families Can Help
Prevention also starts at home. “Family members play a vital role for patient’s safety. Simple changes like removing loose rugs, improving lighting, and installing grab bars in bathrooms can make a big difference,” says Dr Edward.
He also encourages families to keep loved ones active. “Don’t stop them from moving because you’re afraid they will fall. Instead, join them to support for a short walk, help prepare nutritious meals, and accompany them to medical appointments. It’s about empowering, not restricting.”
Towards a Culture of Prevention
Dr Edward believes public awareness is key to change. “Osteoporosis prevention starts young with good nutrition, sunlight, and movement. Strong bones are built over a lifetime.”
Community initiatives such as group exercise sessions, walking clubs, or nutritional workshops can go a long way. “It’s never too early to start taking care of your bones. As we age, maintaining independence and mobility is everything. Strong bones are the foundation for that. Don’t wait for a fall to remind you how precious they are,” says Dr Edward.
