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Osteoporosis

Background:

Osteoporosis is the most common bone disease, characterized by decreased bone mass and poor bone quality, which can lead to back pain, height loss, curving of the spine and increased numbers of fractures: typically of the hip, spine and wrist. A “silent” disease, osteoporosis often develops over many years, with no symptoms or discomfort, until a fracture occurs.

Statistics:

  • to a recent report by the U.S. Surgeon General, osteoporosis is a major public health threat for 34 million Americans.
  • 25 million Americans currently suffer from osteoporosis, and 80 percent are women. Millions more have low bone mass, leaving them susceptible to osteoporosis.
  • is implicated in 1.5 million fractures each year in the U.S. alone, and it is a significant cause of musculoskeletal pain, deformity, disability and even death.
  • are four times more likely to suffer from osteoporosis than men. While a woman’s rate of fracture is two to three times higher than a man’s, death rates in men one year post-fracture are higher: 30 percent of elderly men who suffer a hip fracture will die within a year of that fracture, double the rate for elderly female patients.
  • predict subsequent fractures. An individual’s risk of sustaining additional fractures increases 1.5 to 9.5 times (depending on individual risk factors) after experiencing a first fracture.
  • plays a role in 90 percent of all hip fractures. A woman’s risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancer.
  • fractures – the most disabling of all fractures – lead to 350,000 hospital admissions and 60,000 nursing home admissions annually. About 20 percent of these patients lose their ability to live independently and are admitted permanently to nursing homes, and 50 percent require the use of a walker or cane.
  • history of wrist fracture (which often occurs in younger patients) is associated with a 1.5 to three-fold increased risk for future hip fracture, and a five- to 10-fold risk for future vertebral fracture.
  • October 2004-issued U.S. Surgeon General Report states that in most cases, early identification and proper treatment of osteoporosis can minimize complications resulting from bone disease and decrease the risk for secondary fractures.

Talking Points:

Recommendations for older patients:

  • surgeons recommend bone density tests for all women over age 65 and for any man or woman who suffers even a minor fracture after age 50, as any low-energy fracture is a warning sign that your bones may not be as strong as they should be.
  • you have fallen, ask about the need for a full physical evaluation, including a vision test. Make your home safer by removing items you may trip over, ensuring that you have enough lighting, wearing shoes with good support and installing handrails.
  • daily diet rich in calcium and vitamin D – which helps the body absorb calcium – is a key preventative measure; if your diet does not include these items, supplements are a secondary alternative.
  • least 30 minutes of physical activity daily – including weight-bearing or resistive exercise several times a week –contributes to preventing natural bone loss and strengthens muscles, which helps maintain a sense of balance and coordination: avoiding falls further reduces the risk of fractures.
  • proper treatment, you can reduce your risk of sustaining repeat fractures.
  • medications can aid in preventing bone loss. Estrogen, bisphosphonates, intranasal calcitonin and SERMs provide a wide range of therapeutic choices for prevention and treatment of osteoporosis. Ask your physician about options that may be right for you.

Recommendations for younger patients:

  • is critical for children to maximize their peak bone mass prior to skeletal maturity. Girls generally stop adding to their bone mass around age 14, whereas boys continue to add up until age 18 – 20.
  • bone health starts early in life with good habits like exercise and diet. Bones, like muscles, need exercise to stay strong.
  • exercises like walking, dancing and jogging are best for building and maintaining strong bones.
  • diet with adequate amounts of calcium (1200 mg per day), and vitamin D (400 IU per day) plays an important role in preventing osteoporosis. Calcium-rich foods, many of which are also vitamin D supplemented – such as yogurt, cheese, milk, sardines with bones, and green leafy vegetables like broccoli and collard greens – may help prevent the onset of osteoporosis.

Potential Media Questions:

Q: How can a person prevent osteoporosis?

A: While some things are outside your control – such as hereditary and medical conditions that may make you more susceptible to the disease – you can: ensure your diet includes the recommended daily amounts of calcium and vitamin D; be physically active; talk with your physician about any medications you are on that may cause bones to weaken, or what medicines are safe to take to help protect bones; maintain a healthy weight (being underweight increases the risk of bone loss and fracture); don’t smoke; and limit alcohol use.

Q: What are some risk factors for developing osteoporosis?

A: Being female; being Caucasian or Asian; being menopausal or early menopausal; having a thin and/or small frame; advancing age; a family history of osteoporosis; a diet low in calcium; prolonged use of certain medications, including blood thinners, antiseizures and steroids; smoking; excessive alcohol use; and a sedentary lifestyle.

Q: Is it correct to say that osteoporosis is strictly a woman’s disease?

A: Men start out with bigger bones than women which, because of their size, are harder to break. However, men are not immune from developing osteoporosis: it’s just not an issue for them until many years later, once they reach age 70 and beyond. While menopause is a major cause of bone deterioration in women, factors such as smoking, alcohol consumption and the use of certain medicines increase fracture risks for men. Although fractures are uncommon in men, if a man has a fracture, his risk of re-fracture is higher than that of a woman of the same age. Additionally, men who take glucocorticoids to treat pulmonary disease may be at increased risk for developing osteoporosis, and should undergo a bone density test. A study published in the June 2005 journal, Osteoporosis International, found that only one in every six men who had a spine or hip fracture was treated with osteoporosis medications. According to the same study, just 1.1 percent of men brought to the hospital for a serious fracture received a bone density test to evaluate their overall risk.

Q: What can parents do to keep their children’s bones healthy?

A: Diet and exercise are two habits developed during childhood that determine health for the rest of a lifetime. With this in mind, parents should ensure that children incorporate the proper amounts of calcium and vitamin D into their diets. In addition to milk and other dairy products, dark green leafy vegetables (broccoli) and fish with bones (salmon, sardines) are good sources of calcium, as are almonds and corn tortillas. Many food products, such as orange juice and cereals, may have calcium added to them and can be additional options. Children who drink large amounts of soda cannot possibly take in the amount of calcium that their bodies need to maximize peak bone mass. In terms of exercise, children need at least an hour of physical activity every day.

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