THE OSTEOPOROSIS CAREGIVER: 101
Bone up on what you need to know about the disease.
Osteoporosis, a disease characterized by porous bones, threatens the quality of life of millions of older Americans. As it advances, bones weaken and become brittle, sometimes fracturing from minor falls or even just coughing or sneezing.
Although males develop osteoporosis too, it is four times more common in women than men. Ten million Americans have the disease and another 34 million have low bone density, putting them at risk of developing osteoporosis.
Who is at risk?
Most at risk are slim, small females of Caucasian, Asian or Hispanic descent-and the incidence is increasing most rapidly among Hispanic women. A family history of the disease increases the likelihood of developing osteoporosis. Other contributing factors include poor diet, early menopause, excessive alcohol consumption, tobacco smoke and a sedentary lifestyle. Long-term use of steroid medications and certain illnesses, like thyroid disease or anorexia, add to the risk, too.
Bones continually break down and rebuild, but the rate at which this remodeling proceeds slows with age, making osteoporosis a major public threat for Americans 50 or older. In 2005, it was responsible for more than 2 million fractures. By 2025, if current trends continue, that number is expected to reach three million fractures.
While not curable, osteoporosis is preventable if bone loss is detected early. Once diagnosed, it is treatable. Left untreated, however, it can impede mobility and hasten death. Women start out with lower bone mass than men and lose more after menopause because of decreased estrogen production, putting them at risk of osteoporosis earlier than men. Men are most at risk after age 75.
Called 'the silent thief' because it weakens bones painlessly, osteoporosis advances symptom-free. Most people don't know they have it until they suffer a fracture, most commonly of the hip, spine or wrist, although any bone can be affected. Other signs include severe back pain, loss of height due to vertebral fractures, and spinal deformity, such as a "dowager's hump." Hip fractures, the most feared, usually require surgery or hospitalization and often cause long-term or permanent disability or even death.
Osteoporosis prevention starts in childhood and adolescence. Regular weight-bearing exercise and adequate consumption of calcium and Vitamin D, which is necessary for the body to absorb calcium, are essential for forming strong bones. By age 18, girls have 90 percent of their adult bone mass; boys, by age 20. Peak bone mass occurs at about age 30, after which bone growth slows.
In the five to seven years after menopause, bone loss accelerates rapidly, and women can lose 20 percent of their bone mass in that time period. Because of this, doctors recommend that women with risk factors for osteoporosis consult their doctor well before menopause about possible tests, treatments or necessary lifestyle adjustments. At any age, it is possible to build bone mass.
A bone mineral density test is the best way to detect osteoporosis or osteopenia, which is mild bone loss that increases the risk of developing osteoporosis. Doctors review a patient's risk factors and medical history in determining whether a bone density test is needed. Repeated at intervals of a year or more, these quick, painless tests can track bone loss and help predict the likelihood of fractures.
Bone density tests are recommended for all postmenopausal women with one or more risk factors or postmenopausal women who are not taking hormone therapy; men aged 50 to 70 with one or more risk factors; all women 65 or older and men 70 or older.
Depending on the test results, your doctor may recommend a treatment plan that includes medication, exercise and diet.