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FAST
FACTS ON OSTEOPOROSIS
Definition
 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 susceptibility to fractures, especially of the hip, spine, and wrist,
although any bone can be affected.
Prevalence
 Osteoporosis is a major public health threat for an estimated 44 million
Americans, or 55 percent of the people 50 years of age or older. In the U.S.
today, 10 million individuals are estimated to already have the disease and
almost 34 million more are estimated to have low bone mass, placing them at
increased risk for osteoporosis.
- Of the 10 million Americans estimated to have
osteoporosis, eight million are women and 2 million are men.
- One in two women and one in four men over age 50 will
have an osteoporosis-related fracture in her/his remaining lifetime.
- Significant risk has been reported in people of all
ethnic backgrounds.
- While osteoporosis is often thought of as an older
person's disease, it can strike at any age.
Women
- Eighty percent of those affected by osteoporosis are
women.
- Five percent of non-Hispanic black women over age 50 are
estimated to have osteoporosis; an estimated additional 35 percent have low
bone mass that puts them at risk of developing osteoporosis.
- Ten percent of Hispanic women aged 50 and older are
estimated to have osteoporosis, and 49 percent are estimated to have low
bone mass.
- Twenty percent of non-Hispanic white and Asian women aged
50 and older are estimated to have osteoporosis, and 52 percent are
estimated to have low bone mass.
Men
- Twenty percent of those affected by osteoporosis are men.
- Seven percent of non-Hispanic white and Asian men aged 50
and older are estimated to have osteoporosis, and 35 percent are estimated
to have low bone mass.
- Four percent of non-Hispanic black men aged 50 and older
are estimated to have osteoporosis, and 19 percent are estimated to have low
bone mass.
- Three percent of Hispanic men aged 50 and older are
estimated to have osteoporosis, and 23 percent are estimated to have low
bone mass.
Fractures
- One in two women and one in four men over age 50 will
have an osteoporosis-related fracture in their remaining lifetime.
- Osteoporosis is responsible for more than 1.5 million
fractures annually, including:
- over 300,000 hip fractures; and approximately
700,000 vertebral fractures;
250,000 wrist fractures; and
300,000 fractures at other sites.
Cost
The estimated national direct expenditures (hospitals and nursing homes) for
osteoporotic and associated fractures was $17 billion in 2001 ($47 million each
day) and the cost is rising.
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."
These risk factors include:
- Personal history of fracture after age 50
- Current low bone mass
- History of fracture in a 1st degree relative
- Being female
- Being thin and/or having a small frame
- Advanced age
- A family history of osteoporosis
- Estrogen deficiency as a result of menopause, especially
early or surgically induced
- Abnormal absence of menstrual periods (amenorrhea)
- Anorexia nervosa
- Low lifetime calcium intake
- Vitamin D deficiency
- Use of certain medications, such as corticosteroids and
anticonvulsants
- Presence of certain chronic medical conditions
- Low testosterone levels in men
- An inactive lifestyle
- Current cigarette smoking
- Excessive use of alcohol
- Being Caucasian or Asian, although African Americans and
Hispanic Americans are at significant risk as well
Women can lose up to 20 percent of their bone mass in the five
to seven years following menopause, making them more susceptible to
osteoporosis.
Detection
Specialized tests called bone density tests can measure bone density 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.
- DXA BMD can determine 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, which together, can
optimize bone health and help prevent osteoporosis. They are:
- A balanced diet rich in calcium and vitamin D;
- Weight-bearing exercise;
- A healthy lifestyle with no smoking or excessive alcohol
intake; and
- Bone density testing and 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 one year mortality 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.
- An average of 24 percent of hip fracture patients aged 50
and over die in the year following their fracture.
- One-fourth of those who were ambulatory before their hip
fracture require long-term care afterward.
- At six months after hip fracture, only 15 percent of hip
fracture patients can walk across a room unaided.
- White women 65 or older have twice the incidence of
fractures as African-American women.
Medications
Although there is no cure for osteoporosis, the following medications are
approved by the FDA for postmenopausal women to prevent and/or treat
osteoporosis:
- Bisphosphonates: Alendronate (brand name Fosamax®) and
Risedronate (brand name Actonel®)
- Calcitonin (brand name Miacalcin®)
- Estrogen/Hormone Therapy:
Estrogens (brand names, such as Climara® Estrace®, Estraderm®,
Estratab®, Ogen®, Ortho-Est®, Premarin®, Vivelle®, and others)
Estrogens and Progestins (brand names, such as Activella™, FemHrt®, Premphase®,
Prempro®, and others)
- Parathyroid Hormone: Teriparatide (PTH (1-34), brand name
Fortéo®)
- Selective Estrogen Receptor Modulators (SERMs):
Raloxifene (brand name Evista®)
Alendronate is approved as a treatment for osteoporosis in men
and is approved for treatment of glucocorticoid (steroid)-induced osteoporosis
in men and women. Risedronate is approved for prevention and treatment of
glucocorticoid-induced osteoporosis in men and women.
Parathyroid hormone is approved for treatment of osteoporosis in men who are at
high risk of fracture.
Treatments under investigation include sodium fluoride, vitamin D metabolites,
and other bisphosphonates and selective estrogen receptor modulators.
References:
The NIH
Osteoporosis and Related Bone Diseases ~ National Resource Center
Nutritional and Herbal Therapy for
Osteoporosis
- Calcium (1,000 mg a day, but should be increased
for osteoporosis) is extremely important. If your blood levels are low in
this mineral, calcium will be taken from your bones in order give the
muscles and nerves the amount they need.
- Vitamin D is needed in order to absorb calcium.
- Magnesium (500 mg a day) helps convert Vitamin D
into its usable form.
- Vitamin K is essential for bone mineralization.
Low levels are associated with low bone density.
- Isoflavone has a positve effect on bone
metabolism.
- Vitamins B12 and B6, folic acid keep
homecysteine levels down, which has been linked to osteoporosis risk
-
Dura-Bone is an excellent supplement to strengthen
bones and tendons and help stave off osteoporosis.
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