NHC ANNAPOLIS HEALTH PROMOTION
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WOMEN'S HEALTH
Osteoporosis

Definition
Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures of the hip, spine, and wrist.

Prevalence
Osteoporosisis a major public health threat for 28 million Americans, 80 percent of whom are women. In the U.S. today, 10 million individuals already have osteoporosis and 18 million more have low bone mass, placing them at increased risk for this disease.is a major public health threat for 28 million Americans, 80 percent of whom are women. In the U.S. today, 10 million individuals already have osteoporosis and 18 million more have low bone mass, placing them at increased risk for this disease.

  • Four out of every ten women and one in ten men will have an osteoporosis-related fracture in their lifetime
  • By age 75, one third of all men will be affected by osteoporosis
  • While osteoporosis is often thought of as an older person's disease, it can strike at any age
Osteoporosis is responsible for 1.5 million fractures annually, including:
  • 300,000 hip fractures
  • 700,000 vertebral fractures
  • 200,000 wrist fractures
  • more than 300,000 fractures at other sites

Cost
The estimated national direct expenditures (hospitals and nursing homes) for osteoporosis and associated fractures was $17 billion ($47 million each day) and the cost is rising. Symptoms Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a bone to fracture or a vertebra to collapse. Collapsed vertebra may initially be felt or seen in the form posture or dowager's hump.

Risk Factors
Certain people are more likely to develop osteoporosis than others. Factors that increase the likelihood of developing osteoporosis are called "risk factors."
The following risk factors have been identified:

  • Being female
  • Thin and/or small frame
  • Advanced age
  • A family history of osteoporosis
  • Early menopause
  • Abnormal absence of menstrual periods (amenorrhea)
  • Anorexia nervosa or bulimia
  • A diet low in calcium
  • Use of certain medications, such as corticosteroids and anticonvulsants
  • Low testosterone levels in men
  • An inactive lifestyle
  • Cigarette smoking
  • Excessive use of alcohol
  • Caucasian or Asian, although African Americans and Hispanic Americans are at significant risk as well
Women can lose up to 20% of their bone mass in the 5-7 years following menopause, making them more susceptible to osteoporosis. However, 2.0 million American men are affected by osteoporosis and one out of ten men age 50 and older will develop fractures. White women 60 years of age or older have at least twice the incidence of fractures as African-American women. However, one out of five African-American women are at risk of developing osteoporosis.

Detection
Specialized tests called bone density tests can measure bone density in various sites of the body. A bone density test can:

  • Detect osteoporosis before a fracture occurs
  • Predict your chances of fracturing in the future
  • Determine your rate of bone loss and /or monitor the effects of treatment if the test is conducted at intervals of a year or more

Prevention
Building strong bones,
especially before the age of 35, can be the best defense against developing osteoporosis, and a healthy lifestyle can be critically important for keeping bones strong. So, to help prevent osteoporosis:

  • Eat a balanced diet rich in calcium
  • Exercise regularly, especially weight-bearing activities
  • Don't smoke and limit alcohol intake
  • Talk to your doctor if you have a family history of osteoporosis or no longer
  • have the protective benefit of estrogen due to natural or surgically induced menopause.

Fractures
The most typical sites of fractures related to osteoporosis are the hip, spine, wrist, and ribs, although the disease can affect any bone in the body. Forty percent of all women will have at least one spinal fracture by the time they reach age 80. Spinal osteoporosis is eight times more likely to afflict women than men. The rate of hip fracture is four times higher in women than men; however, the death rate for men within one year after a hip fracture is 26 percent higher than in women. A woman's risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancer. About 300,000 Americans age 55 and over are admitted to hospitals with hip fractures annually. Osteoporosis is the underlying cause of many of these injuries. Among those who were living independently prior to a hip fracture, 15 to 25 percent are still in long-term care institutions a year after the injury.

Treatment and Care
Although there is no cure for osteoporosis, there are treatments available to help stop further bone loss and fractures:

  • Studies have shown that estrogen can prevent the loss of bone mass in postmenopausal women.
  • Alendronate, a bisphosphonate, has been approved by the Food and Drug Administration for treatment of postmenopausal osteoporosis.
  • Calcitonin is a treatment that can be used by women and men for osteoporosis.
  • This drug has been shown to slow bone breakdown and also may reduce the pain associated with osteoporotic fractures.
  • Other treatments include different bisphosphonates, sodium fluoride, vitamin D metabolites, and selective estrogen receptor modulators.

 

For more information: National Osteoporosis Foundation