Wear a White Ribbon for Osteoporosis Awareness and Prevention Month
The Bone Health and Osteoporosis Foundation has designated May as National Osteoporosis Awareness and Prevention Month. It may surprise you to know that fractures related to osteoporosis account for more hospitalizations than heart attacks, strokes and breast cancer combined. The most common sites of fracture in a person with osteoporosis are hip, vertebrae and wrist.
Osteoporosis is defined as a bone disease that develops when bone mineral density and mass decreases, or when the quality or structure of the bone changes. These changes lead to a decrease in bone strength that can increase the risk of fractures. 10 million Americans over the age of 50 have osteoporosis, and another 44 million have low bone density, which may progress to osteoporosis. Peak bone mass is achieved in the 20’s so it is important for young adults and even children to be aware of ways to optimize that bone mass, as well as the risk factors for osteoporosis. The main preventive measures include regular weight-bearing exercise, and getting adequate calcium and vitamin D intake.
The recommended weight bearing exercises can be high-impact such as dancing, aerobics, hiking, jump-roping; or low-impact like using stair-stepper or elliptical machines or even fast walking. Things that can strengthen muscles and bone density include lifting weights, using elastic bands or weight machines, or even wearing a weighted vest throughout the day doing your usual activities.
Osteoporosis is generally considered a disease of women and older people, and while those groups are most at risk, men and younger people can also develop it. Other risk factors which increase a person’s risk include: smoking, family history, excess alcohol use, being small or thin, and being of white or Asian ethnicity. Certain medications including prednisone, seizure medicines and acid medicines can also put one at risk. Women are at most risk in the post-menopausal years mainly due to low levels of estrogen. In younger women, low estrogen can be caused by other conditions and medications, putting them at risk also.
USPSTF (U.S. Preventive Services Task Force) recommends all women over the age of 65 and other individuals with risk factors should have screening for osteoporosis. The main screening tool is DEXA scan (dual-energy x-ray absorptiometry.) It is a quick non-invasive test which uses low levels of x-ray to measure bone mineral density at the hip and spine. The newer machines can also measure trabecular bone score, which is also important in evaluating risk for fractures. Using patient age and measurements as well as risk factors and the numbers obtained from these screenings, a FRAX score can be calculated. This FRAX score gives an estimate of that particular individual’s risk for fracture and can be used to guide treatment recommendations. This testing is available at Gateway Clinic in Moose Lake.
For those who do have low bone density or osteoporosis- it is important to continue getting adequate Calcium and Vitamin D as well as regular exercise and to take measures to prevent falls. This might include avoiding medication which can affect balance, using a cane or walker, wearing good shoes, keeping rooms free of clutter and being aware of the surfaces you are walking on. The medicines which are used to treat osteoporosis act by slowing reabsorption of bone or promoting new bone formation. These include bisphosphonates which come in oral and injectable forms, as well as medicines which act by increasing estrogen levels. Your physician or other provider can discuss which medicine is best for you based on your situation and other health issues.
For more information:
bones.nih.gov – NIH Osteoporosis and related Bone diseases National Resource Center
bonehealthandosteoporosis.org – Bone Health and Osteoporosis Foundation
Dr. Bridget Dewey M.D., Internal medicine/Pediatrics
Gateway Family Health Clinic