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April 2, 2001
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SENIOR HEALTH
Information from The National Osteoporosis Foundation By The National Osteoporosis Foundation 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
Osteoporosis is a major public health threat for more than 28 million Americans, 80 percent of whom are women. In the U.S. today, 10 million individuals already have the disease and 18 million more have low bone mass, placing them at increased risk for osteoporosis.
80% of those affected by osteoporosis are women.
In America, 8 million women and 2 million men have osteoporosis, and millions more have low bone density.
One in two women and one in eight men over age 50 will have an osteoporosis-related fracture in their lifetime.
10% of African-American women over age 50 have osteoporosis; an additional 30% have low bone density that puts them at risk of developing osteoporosis.
Significant risk has been reported in people of all ethnic backgrounds.
While osteoporosis is often thought of as an older person's disease, it can strike at any age.
Osteoporosis is responsible for more than 1.5 million fractures annually, including 300,000 hip fractures, approximately 700,000 vertebral fractures, 250,000 wrist fractures, and 300,000 fractures at other sites.
Cost
The estimated national direct expenditures (hospitals and nursing homes) for osteoporotic and associated fractures were $13.8 billion in 1995 ($38 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 fracture or causes a vertebra to collapse.
Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis, or stooped posture.
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
Postmenopause, including early or surgically induced 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
Being 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
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
By about age 20, the average woman has acquired 98% of her skeletal mass. Building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later. A comprehensive program that can help prevent osteoporosis includes:
A balanced diet rich in calcium and vitamin D
Weight-bearing exercise
A healthy lifestyle with no smoking or excessive alcohol use
Bone density testing and medication when appropriate
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.
The rate of hip fractures is two to three times higher in women than in men; however, the one-year mortality following a hip fracture is nearly twice as high for men as for women.
A woman's risk of hip fracture is equal to her combined risk of breast, uterine, and ovarian cancer.
In 1991, about 300,000 Americans age 45 and over were admitted to hospitals with hip fractures. Osteoporosis was the underlying cause of most of these injuries.
An average of 24% of hip fracture patients age 50 and over die in the year following their fracture.
One-fourth of those who were ambulatory before their hip fracture require long-term care afterward.
White women 65 or older have twice the incidence of fractures as African-American women.
Medications
Although there is no cure for osteoporosis, the following medications are approved by the FDA for postmenopausal women to prevent and/or treat osteoporosis:
Estrogens (brand names such as Premarin, Estrace, Ogen, Prempro, Estraderm, and Estratab and others)
Calcitonin (brand name Miacalcin)
Alendronate (brand name Fosamax)
Raloxifene (brand name Evista)
Risedronate (brand name Actonel)
Alendronate and risedronate are approved for use in glucocorticoid-induced osteoporosis in both men and women
Treatments under investigation include sodium fluoride, vitamin D metabolites, parathyroid hormone, other bisphosphonates, and SERMs. The most typical sites of fractures related to osteoporosis are the hip, spine, wrist, and ribs, Medical experts agree that osteoporosis is highly preventable. However, if the toll of osteoporosis is to be reduced, the commitment to osteoporosis research must be significantly increased. It is reasonable to project that with increased research, the future for definitive treatment and prevention of osteoporosis is very bright. The National Osteoporosis Foundation is the nation's leading resource for patients, healthcare professionals, and organizations seeking up-to-date, medically sound information on the causes, prevention, diagnosis, and treatment of osteoporosis. Please contact us to learn more about NOF, National Osteoporosis Prevention Month.
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