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An Overview of Osteoporosis

Osteoporosis (Degenerative Arthritis), or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to frail bones and an increased risk of fractures of the hip, spine, and wrist. Men as well as women are affected by osteoporosis, a disease that can be prevented and treated.

Facts and Figures

  • Osteoporosis is a major public health threat for 44 million Americans, 68 percent of whom are women.
  • In the U.S. today, 10 million individuals already have osteoporosis and 34 million more have low bone mass, placing them at increased risk for this disease.
  • One out of every two women and one in four men over 50 will have an osteoporosis-related fracture in their lifetime.
  • More than 2 million American men suffer from osteoporosis, and millions more are at risk. Each year, 80,000 men have a hip fracture and one-third of these men die within a year.
  • Osteoporosis 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 more than 300,000 fractures at other sites.
  • Based on figures from hospitals and nursing homes, the estimated national direct expenditures for osteoporosis and related fractures total $14 billion each year.

What Is Bone?

Bone is living, growing tissue. It is made mostly of collagen, a protein that provides a soft framework, and calcium phosphate, a mineral that adds strength and hardens the framework.

This combination of collagen and calcium makes bone both flexible and strong, which in turn helps it to withstand stress. More than 99 percent of the body’s calcium is contained in the bones and teeth. The remaining 1 percent is found in the blood.

Throughout your lifetime, old bone is removed (resorption) and new bone is added to the skeleton (formation). During childhood and teenage years, new bone is added faster than old bone is removed. As a result, bones become larger, heavier, and denser. Bone formation outpaces resorption until peak bone mass (maximum bone density and strength) is reached around age 30. After that time, bone resorption slowly begins to exceed bone formation.

For women, bone loss is fastest in the first few years after menopause, and it continues into the postmenopausal years. Osteoporosis – which mainly affects women but may also affect men – will develop when bone resorption occurs too quickly or when replacement occurs too slowly. Osteoporosis is more likely to develop if you did not reach optimal peak bone mass during your bone-building years.

Risk Factors that Contribute to Osteoporosis in Seniors

Certain risk factors are linked to the development of osteoporosis and contribute to an individual’s likelihood of developing the disease. Many people with osteoporosis have several risk factors, but others who develop the disease have no known risk factors. There are some you cannot change and others you can.

Risk factors you cannot change

  • Gender – Your chances of developing osteoporosis are greater if you are a woman. Women have less bone tissue and lose bone faster than men because of the changes that happen with menopause. However, men do get osteoporosis.
  • Age – The older you are, the greater your risk of osteoporosis. Your bones become thinner and weaker as you age.
  • Body size – Small, thin-boned women are at greater risk.
  • Ethnicity – Caucasian and Asian women are at highest risk. African American and
  • Hispanic women have a lower but significant risk.
  • Family history – Fracture risk may be due, in part, to heredity. People whose parents have a history of fractures also seem to have reduced bone mass and may be at risk for fractures.

Risk factors you can change

  • Sex hormones – Abnormal absence of menstrual periods (amenorrhea), low estrogen level (menopause), and low testosterone level in men can bring on osteoporosis.
  • Anorexia nervosa – Characterized by an irrational fear of weight gain, this eating disorder increases your risk for osteoporosis.
  • Calcium and vitamin D intake – A lifetime diet low in calcium and vitamin D makes you more prone to bone loss.
  • Medication use – Long-term use of glucocorticoids and some anticonvulsants can lead to loss of bone density and fractures.
  • Lifestyle – An inactive lifestyle or extended bed rest tends to weaken bones.
  • Cigarette smoking – Cigarettes are bad for bones as well as the heart and lungs.
  • Alcohol intake – Excessive consumption increases the risk of bone loss and fractures.

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 hip to 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 (severely stooped posture).

Detecting and Preventing Osteoporosis

Following a comprehensive medical assessment, your doctor may recommend that you have your bone mass measured. A bone mineral density (BMD) test is the best way to determine your bone health. BMD tests can identify osteoporosis, determine your risk for fractures (broken bones), and measure your response to osteoporosis treatment. The most widely recognized bone mineral density test is called a dual-energy x-ray absorptiometry or DXA test. It is painless – a bit like having an x ray, but with much less exposure to radiation. It can measure bone density at your hip and spine.

A comprehensive osteoporosis treatment program includes a focus on proper nutrition, exercise, and safety issues to prevent falls that may result in fractures. In addition, your physician may prescribe a medication to slow or stop bone loss, increase bone density, and reduce fracture risk.

Exercise

Like muscle, bone is living tissue that responds to exercise by becoming stronger. Weight-bearing exercise is the best for your bones because it forces you to work against gravity. Examples include walking, hiking, jogging, stair climbing, weight training, tennis, and dancing.
Preventive medications

Various medications are available for preventing and treating osteoporosis.

The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research. NIH annually invests over $28 billion in medical research.

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