|Osteoporosis Prevention: A Gift for Mother's Day|
by Allen Weiss, MD, MBA, FACP, FACR
President, NCH Healthcare System
May 12, 2006 - For Mother’s Day this year make your mom, wife, daughter, or loved one aware about the risks, diagnosis, prevention, treatment and prognosis for osteoporosis, the “silent crippler.” Flowers and candies are nice but keeping your family and friends healthy is more important in the long run.
Osteoporosis is among the most under recognized, under treated, under appreciated (as to severity) and easiest to treat preventable illnesses that face both women and men today. Osteoporosis is known as the “silent crippler” because bone loss begins slowly and silently at about age twenty, potentially culminating in a life threatening fracture. Osteoporosis is estimated to affect 55% of Americans over the age of 55, with four out of five victims being women.
The chance of a fracture of the forearm, vertebrae (back bone), and hip increases with age, with a hip fracture having the greatest chance of disability and death. “A woman's risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancer.” This startling fact has been reported by the National Osteoporosis Foundation (NOF). Also, according to the NOF, “An average of 24 percent of hip fracture patients aged 50 and over die within the a year following their fracture.” Osteoporosis is not to be taken lightly; it is a disease that is often not even diagnosed until the fracture changes one’s life.
Why do women have four times the chance as men of having osteoporosis with fractures? Women have smaller body frames to begin with so they cannot store as much calcium earlier in life. Peak bone mass occurs in the early twenties with a gradual erosion over time. Being sedentary, smoking, excess alcohol intake, certain medicines such as anti-convulsants, low calcium intake, lack of Vitamin D, having a family history of osteoporotic fractures, along with being Caucasian or Asian—all increase the chances of suffering from osteoporosis later in life.
How do you know if you have osteoporosis? If you are at risk, namely over 55 and have any of the above characteristics, then you should have a bone density test. This is a simple, painless form of diagnostic x-ray which compares the density of your hip bone with others of your age and gender as well as telling the physician what the chances are of your having a fracture in the future. Medicare and most insurance companies cover the cost of the test if performed not more than once every two years. Even if you don’t have any risk factors, the case can be made for at least a one-time screening test to preclude the existence of osteoporosis.
Prevention is clearly the best form of treatment. Having a healthy life style, including a diet rich in calcium and Vitamin D, along with weight bearing exercises are keys to prevention. Avoiding excess alcohol and smoking are salubrious for both osteoporosis and health in general.
Fortunately, there are a host of new effective treatments for osteoporosis, including a group of medicines which stop further bone loss and, with time, prevent future fractures by building new bone. Estrogens and certain other hormones are used in special cases for treatment as well. All of these treatments need to be initiated and monitored by the physician.
This Mother’s Day should be special for those people we care for every day. Let’s work to make their future prognosis better by preventing when possible and treating when necessary the serious consequences of osteoporosis.
Dr. Allen Weiss is President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.