Osteoporosis

• 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 risk of fractures of the hip, spine and wrist.

Prevalence:               

• In the U.S: 10 million individuals already have osteoporosis. 18 million more have low bone mass, placing them at increased risk for osteoporosis.
• 80 percent of those affected are women. 
• Eight million American women and 2 million men have osteoporosis.
• One in two women and one in eight men over age 50 will have an osteoporosis-related fracture in their lifetime.
• One in ten African-American women over age 50 have osteoporosis; an additional one in 3 have low bone density that puts them at risk of developing osteoporosis.
• While osteoporosis is often thought of as an older person's disease, it can strike at any age.
• Osteoporosis accounts for one fracture every 20 seconds or 4,110 fractures per day.
• Osteoporosis is responsible for more than 1.5 million fractures annually, including:
  
  
• 300,000 hip fractures
• 700,000 vertebral fractures
• 250,000 wrist fractures
• 300,000 fractures at other sites.

Cost of osteoporosis:

• The estimated national direct expenditures (hospitals and nursing homes) for osteoporotic and associated fractures was $13.8 billion in 1995 ($38 million each day).

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 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."  They include:
  
  
• Being female
• A thin and/or small frame
• Advanced age
• A family history of osteoporosis
• Menopause, including early or surgically induced menopause
• Abnormal absence of menstrual periods (amenorrhoea)
• 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 (this does NOT mean that African Americans and Hispanic Americans are not at risk)

• Women can lose up to one fifth of their bone mass in the five to seven years following menopause, putting them at an even greater risk.

Detection:

• Bone density tests can measure bone mass 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 percent of her skeletal mass. Building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later. There are four steps to prevent osteoporosis.  No one step alone is enough to prevent osteoporosis but all four may.  They are:
  
  
• Eat a balanced diet rich in calcium and vitamin D.
• Practice regular weight-bearing exercise.
• Live a healthy lifestyle with no smoking or excessive alcohol intake.
• Have bone density testing or take 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 men; however the risk of death one year 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.
• Nearly one in 4 hip fracture patients age 50 and over die in the year following their fracture.
• One out of four hip fracture patients who were living independently before their hip fracture require long-term care afterward.
• White women 65 or older have twice the incidence of fractures as African-American women.
• Approximately 90% of hip fractures can be attributed to osteoporosis in white women over age 65.  For women over 85, 95% of hip fractures can be attributed to osteoporosis.

Osteoporosis and Men:

• 2 million men have osteoporosis; another 3.6 million are at increased risk from low bone mass.
• The risk of death following a hip fracture is nearly twice as high for men as women.
• Nearly 80% of hip fractures can be attributed to osteoporosis in men over 64; for men over 84, 85% of hip fractures can be attributed to osteoporosis.

Medications:

• There is no cure for osteoporosis. The following medications are approved by the FDA for postmenopausal women to prevent and/or treat osteoporosis:
  
  
• Estrogen replacement therapy (e.g. brand names such as Premarin®, Ogen®, Estrace®, Estraderm®, Estratab®, Prempro® and others)
• Alendronate (brand name Fosamax®)
• Calcitonin (brand name Miacalcin®)
  
• Raloxifene (brand name Evista®)
• Risedronate (brand name Actonel®)

Click here for more information on osteoporosis.

Source:  National Osteoporosis Foundation (http://www.nof.org)

Created: 5/8/2001  -  Donnica Moore, M.D.