Osteoporosis is a weakening of bone that leads to more than 1.3 million fractures each year in this country. The probability that a 50-year-old woman will have a hip fracture during her lifetime is 14%. In a recent survey of women over the age of 75 more than 80% responded that they would prefer death to having a hip fracture and living in a nursing home.

The emotional and physical consequences of a fracture are profound. Fear, anxiety, loss of independence and self-esteem has a significant impact on the patient and family.

The good news is that there are simple and painless tests (bone density) to diagnose osteoporosis at an early stage and there are treatments to help prevent the consequences of fracture.

DR. DAVID MANDEL’S TOP TEN LIST FOR OSTEOPOROSIS

1. What are common risk factors for developing osteoporosis? Family history, previous history of a fracture, history of cigarette smoking and excess alcohol use, and long-term use of Cortisone are some of the more common risk factors. The more risk factors you have the greater likelihood of developing osteoporosis.
2. Is it normal to lose height, as one gets older? The most common cause of height loss as one ages is osteoporosis and this should be further evaluated.
3. Are there any medical illnesses that predispose people to osteoporosis? Crohn’s disease, ulcerative colitis and other diseases that can cause malabsorption of calcium and vitamin D from the intestine. Over and under active thyroid and parathyroid can lead to low bone mass.
4. What is the best test to diagnosis osteoporosis? A DXA scan is the most accurate method to diagnosis osteoporosis. This test can provide information regarding a patient’s risk of a future fracture.
5. What is the best time to have a DXA scan performed? Since menopause is a time of potential bone loss for all women, a baseline DXA scan is recommended. Younger women and men should have DXA scans performed if they have several clinical risk factors.
6. Are there medicines that can cause osteoporosis? Prednisone is the most commonly used medication, which can cause osteoporosis. A patient taking as little as 10-15 mg. of Prednisone daily may lose as much as 15% of their bone density in their spine after just 9 months.
7. What medications are available to prevent and treat osteoporosis? Prevention: Estrogen, Evista, Miacalcin (nasal spray) Treatment: Evista, Bisphosphonates: Didronel*, Fosamax, Actonel
8. Can men develop osteoporosis? Yes! Common risk factors in men are smoking and excessive drinking. Low testosterone levels are a less common cause. The consequences of a hip fracture in an older man are devastating. More than 30% of men will die from other medical complications after sustaining a hip fracture.
9. What is the best source of calcium? Foods that are rich in calcium are the best source, i.e. milk and dairy products, squash, broccoli. For those unable to obtain this from their diet, calcium supplements are very important. It is recommended that postmenopausal women have 1500mg. of calcium daily along with 400-800 units of vitamin D.
10. What exercises can help strengthen bone? Bone is living tissue and weight bearing exercises, i.e. walking, using free weights, stress and stimulate bone growth. Exercise helps to also strengthen muscles, which support bone and can improve one’s gait and balance.

CONCLUSION: This is a most promising time in dealing with osteoporosis. We can begin healthy nutritional and exercise programs for our children so that they can maximize their bone mass during adolescence. We can now diagnose bone loss at an earlier stage and monitor changes as we now have therapies to strengthen bone.

THE TIME IS NOW FOR TREATMENT AND PREVENTION OF OSTEOPOROSIS

* Is medically used but not FDA approved.