الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Involutional osteoporosis is one of the most common bone ’,’Orders affecting postmenopausal women and the elderly. It is aracterized by a reduction of bone mass to a degree which ~nders it susceptible to fracture even with minimal trauma. Jltiple risk factors may act independently or in combination to oduce diminished bone mass in an individual patient. Fractures :cur most frequently at the spine, the hip and the wrist. These letures lead to significant morbidity and mortality and a Insequent high economic burden on the community. As the derly population is growing, so will be the magnitude of the oblem. The aim of the present study was to determine the ’evalence of involutional osteoporosis and its associated risk group of males and females aged 50 years or re. It aimed also to identify the impact of an intervention ogram of health education and Ca supplementation on ’[eoporotic patients. The study was carried out at Alexandria Main University Ispital. The sample included all elderly attending the geriatric tpatient clinic and 20 of attendents of the internal medicine lie on 2 chosen days each week for a period of 6 months. The ,er sample was chosen by systcll1atic random technique method. :Iusion criteria were: Age (50 years or more), acceptance, ,sence of a history suggestive of a secondary cause of leoporosis. All females had to be at least 6 months stmenopause. The total sample was 112; including 69 females and 43 males. They were classified into three groups: Group I: 5059 years, Group II: 60-69 years, Group Ill: 70 years or more. The work in this study was divided into two parts; data collection and intervention program. Part one: Data collection: Five tools were utilized: 0 Interviewing questionnaire: It included: I. Personal and sociodemographic characters e.g. Age, Sex, marital status, residence, occupation, education, income, family size and home sanitation. The socioeconomic level was determined. 2, Factors influencing osteoporosis. It included: A. Lifestyle factors. e.g. coffee and alcohol intake, smoking, sun exposure and the practice of physical exercise. B. Nutrient intake assessment. Included Ca, P, protein and Vit. D. C. Reproductive history of the females. It included age at menopause, duration since menopause, parity, breast feeding and the previous use of contraceptive pills. 3, Medical history. It included history of bone and backaches, past history of diseases, fractures, operations, family history of recurrent backaches and fracture with mild trauma. 4. Knowledge assessment. Data were collected to assess the participants knowledge about different aspects of osteoporosis. n, Anthropometric. measurements. Weight and height were measured and B. M.I was calculated. Ill. Complete physical examination. General and systemic examination were carried out for each participant. IV. Laboratory investigations. Were done to exclude secondary causes of osteoporosis and it included: Complete: urine analysis, complete blood picture, E.S.R, F.B.S, serum creatinine, serum Ca, P and alkaline phosphatase. V. Radiological investigations. It included: !. X-ray lumbosacral spine (lateral view). It was done to detect signs of osteoporosis, fracture of the spine and to exclude secondary causes of osteoporosis. 2. X-ray both hips. This X-ray was done to estimate the following: A. Singh index Assessment of the trabecular pattern of upper end of femur according to Singh index grading. B. Optical bone density measurement: The optical bone density of both hips were measured using an automatic densitometer type 102. The mean and standard deviation of bone density for each age group were calculated. Diagnosis of osteoporosis was carried out if the bone density of the participant was more than one standard deviation below the mean for his age group. Part two: Intervention program The total number of osteoporotic patients was 23; 15 females and 8 males. They were classified into an experimental and control )Ups. The program was conducted to the experimental group only d extended for a period of 6 months. It included: 1) ”eaIth education. Twice monthly settings were held for the period of the program. Talks, discussions, demonstrations and visual materials were utilized to enhance the knowledge of the participants about osteoporosis, Motivate them to increase their dietary Ca intake and to practice physical exercise regularly. R) Ca supplementation. Ca gluconate was supplied to each participant in a dose of 0.5 gm twice daily for six months. Evaluation of the program after 6 months was carried out using the foHowing tools: the same interviewing questionnaire, ~boratory investigations (Ca, P, alkaline phosphatase) and optical bone density measurements for both the experimental and control groups.