Osteoporosis is called a "silent disease" for a reason. Oftentimes, the first sign that a person has osteoporosis occurs after a fall that results in a broken hip or fractured wrist. Bone loss occurs without symptoms, so people may not know that they have osteoporosis (literally, porous bone) until their bones become so weak that a sudden strain, bump or fall causes a fracture or a vertebra to collapse.
An estimated 10 million Americans - 80 percent of them women - have osteoporosis. Another 34 million Americans over age 50 have low bone mass, putting them at risk of developing osteoporosis and related fractures. In their lifetime, one out of two women and one out of four men will suffer an osteoporosis-related fracture. As the U.S. population ages, the incidence of osteoporosis is expected to rise, as is the number of hip fractures among older adults.
Bones are living tissues that change constantly throughout our lifetime. As we age, our bones begin to break down faster than new bone is formed. This bone loss accelerates for women after menopause, when their ovaries cease producing estrogen, a hormone that protects against bone loss. Men, on the other hand, have larger, stronger bones, which may explain why fewer of them are affected by osteoporosis.
Risk factors for osteoporosis include a family history of the disease, personal history of a fracture before age 50, being female, advanced age, and current low bone mass. In addition, men whose hormone levels are altered by chronic diseases of the kidneys, lungs, stomach and intestines are at increased risk, as are men with undiagnosed low levels of the sex hormone testosterone.
Experts say that osteoporosis is a preventable disease. Prevention is extremely important because, while there are a number of treatments for osteoporosis, there is currently no cure. The best defense against developing osteoporosis is building strong bones, especially before the age of 30.
A balanced diet rich in calcium and vitamin D, weight-bearing exercise, and a healthy lifestyle with no smoking or excessive alcohol consumption are all measures that can help prevent osteoporosis. While taking these steps individually is not enough, taken together they may help ward off the disease.
Another component of prevention is screening through bone mineral density (BMD) testing. This test, also called bone densitometry, measures the amount of mineral in certain parts of bone, telling doctors how strong your bones are. This quick and painless test can help detect osteoporosis before a fracture occurs, predict your chances for a fracture in the future, determine your rate of bone loss, and monitor your response to treatment if you have osteoporosis.
All women over the age of 65 should have a baseline BMD test. BMD testing may also benefit younger women, who should check with their physician about when and how often to have their bone density tested.
In addition to women over 65, the National Osteoporosis Foundation recommends BMD testing for:
- Postmenopausal women under age 65 with one or more risk factors for osteoporosis (besides menopause);
- Postmenopausal women who present with a fracture;
- Women considering therapy for osteoporosis, if testing would facilitate the decision;
- Men and women with fractures or hypothyroidism; and
- Men and women who take corticosteroids.
A number of treatments are designed to help slow down or stop the loss of minerals in bone, prevent fractures, and reduce the pain associated with the disease. Medications, including Fosamax and Actonel, slow down bone loss and, in some cases, increase bone mineral density. In addition, hormones such as teriparatide (parathyroid hormone) may increase bone density and promote new bone growth.
Lifestyle modifications are also important for the treatment and prevention of osteoporosis, as well as for warding off fractures. Diet, weight-bearing exercises, and vitamins and supplements can all help bone mass and reduce the likelihood of fractures associated with osteoporosis.
At Hebrew SeniorLife, researchers are involved in a number of studies aimed at learning more about the cause, prevention and treatment of osteoporosis, including the association between dietary and genetic factors and bone loss, as well as new treatments for the disease such as hip protectors and low-level mechanical stimulation.