When you think about osteoporosis, the image of a frail elderly woman might flash through your mind.
That would be, as my teachers used to tell me, an incomplete answer.
The disease that makes bones weak and increases the likelihood of fractures is actually a big problem for men too.
Dr. Shireen Fatemi is the Regional Osteoporosis Physician Co-leader at in Panorama City, California. She has been practicing for nearly a quarter of a century and over a decade ago helped launch the award winning Healthy Bones Program with Kaiser Permanente Southern California.
She told the National Pain Report that patients shouldn’t wait until they are seniors to start thinking about a prevention program. More on that later.
First, what are the risk factors for this disease?
“If there’s a family history that’s always something to consider,” said Dr. Fatemi. “In addition, older people, women more than men and folks who have used steroids to treat arthritis, asthma and chemotherapy are also higher at risk.”
Osteoporosis is responsible for 1.5 million fractures in the U.S. annually at a cost of $14 billion. About half of all women and a quarter of all men over the age of 50 will break a bone due to osteoporosis, according to the National Institutes of Health.
The truth is as we get older our bones tend to weaken and your doctor will be more likely to recommend a bone density screening. Menopause will increase bone loss in women rather dramatically, so women are at risk a little earlier in life. Women at 65 and men at 70 are very susceptible to Type 2 Osteoporosis which causes bone loss of up to 1% a year.
And as bone loss intensifies so does the risk of fractures, particularly spine and hips. The statistics are a little unsettling. One in three men who have a hip fracture die within one year. Women do a little better statistically (a mortality rate of 25% in the first year), but the risk of death is still very high.
By the way, there’s a pretty interesting way to see if you or a loved one like an elderly parent is at risk for bone fracture here.
So what can we do?
“Patients need to understand that they can’t stop osteoporosis, but they can slow it down, manage and avoid aggravating it,” said Dr. Fatemi.
Her recipe sounds pretty reasonable:
- Adopt a healthy lifestyle
- Increase (or start) exercise — especially weight bearing exercises like walking, hiking, yoga, low weight lifting
- Avoid smoking (pretty much every doctor tells you that)
- Avoid excessive alcohol consumption
- Take calcium supplements (most of us, especially as we get older, can’t get all we need from food)
- Take Vitamin D supplements to help bones absorb calcium (Dr. Fatemi says approximately 50% of the population is deficient in Vitamin D).
She emphasized the importance of exercise.
“If we can improve our balance and our strength, we will reduce the number of times we fall, and it is a fall that can break a hip or fracture a spine,” she said.
When muscles and bones are healthy, we are apt to fall less and when we fall less, we are less apt to break any bones.
But exercise alone may not be enough.
If you watch television, you see a lot of commercials for different products (brand names like Actonel, Boniva, Fosamax) in a drug class called bisphosphonates that can inhibit bone breakdown, preserve bone mass and even increase bone density in hips and spines.
But the most important discussion you can have is with your physician.
“Questions like whether a woman should use hormone replace therapy to stem the estrogen loss or whether a person should have anti-absorptive therapy should be posed to your physician and treat based on the individual risk factors,” said Dr. Fatemi.