Increased acceleration in bone loss because of the loss of natural estrogen

Women whose ovaries have stopped functioning, such as women being treated for the prevention and treatment of ovarian and breast cancer

Declining testosterone levels

Genetic factors (60% - 80%)

Thyrotoxicosis Hyperparathyroidism Anorexia nervosa Cushing’s syndrome Long term use of medications such as thyroid hormone, anticonvulsants, furosemide and corticosteroids History of low-trauma fracture in a 1st degree relative

Low body weight (less than about 128 lbs) Current cigarette smoking Impaired vision Dementia Poor health/frailty Recent falls Inadequate physical activity Low intake of dietary calcium (lifelong) Suboptimal levels of serum vitamin D Alcohol in amounts of more than two drinks per day Personal history of fracture

Aging

Increased duration of bone loss

Change in bone architecture

Aging of bone tissue

Accumulation of microdamage

Thinning of bone cortex

Marked weakness of bones

Progressive bone deformities

Fracture

Functional disability

Physical immobility Shortened stature Compression fracture for vertebral deformities

Progressive dorsal kyphosis

DEVELOPMENT OF DECUBITUS ULCERS

Resting of lower ribs on iliac crest

Pain accompanied by skeletal fractures

Downward pressure on viscera

Restricted lung expansion

Impaired respiration Abdominal distention and bloating Pain Generalized hypoxia

Anoxia

DEATH

Osteoporosis

Aging

Physical immobility

Decrease in circulation

Incontinence

Decreased nutrients to periphery

Moisture

Skin maceration Restricted movements Fixed position Displacement of tissue External pressure Friction Shearing force

Skin breakdown

Disruption of blood flow to capillary beds and arterioles Stretching or rupture to blood vessels

Decubitus ulcer

Edema, autolysis of cells

Tissue ischemia

Decubitus ulcer

Worsening of tissue injury

Increased depth of wound Tunneling / fistulas

Infection

Systemic sepsis

DEATH

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