Facts About Osteoporosis

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 of the hip, spine and wrist.

Prevalence of Osteoporosis

  • 25 million Americans affected -- 80% are women
  • 7-8 million have osteoporosis; 17 more million have low bone mass and increased risk
  • In Missouri -- an estimated 598,000 men and women over the age of 50 have either low bone mass or osteoporosis
  • One of every two women and one in eight men will have an osteoporosis-related fracture
  • By age 75, one-third of all men will be affected
  • Not merely an older persons disease; it strikes at any age
  • Responsible for 1.5 million fractures annually, including 300,000 hip fractures, 700,000 vertebral fractures, 200,000 wrist fractures and more than 300,000 fractures at other sites
  • Loss of dentition is also related to bone loss (in the mandible)
  • 40 percent of all women will have at least one spinal fracture by age 80
  • A woman's risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancer
  • Individuals suffering hip fractures have 5 to 20 percent greater risk of dying within the first year following the fractures than others in their age group
  • Among those who were living independently prior to a hip fracture, 15 to 25 percent are still in long-term care institutions a year after the injury
  • More than 40 to 50 percent of individuals taking drugs for chronic diseases, such as asthma and rheumatoid arthritis, often have severe osteoporosis, which can be treated

Cost of Osteoporosis

  • $10-16 billion annually in direct expenditures for hospital and nursing homes
  • $27 million daily

Symptoms of Osteoporosis

  • Osteoporosis is called the Silent Disease -- bone loss occurs without symptoms
  • The first external sign of osteoporosis is back or hip pain; when a fracture occurs with pain, the bone has become so weakened that any mild stress will cause it to break
  • Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities

Risk Factors of Osteoporosis

  • Unchangeable Risk Factors
  • Female
  • Thin and/or small frame
  • Advanced age
  • Family history
  • Early menopause
  • Late menarche (onset of menstruation later than 15 years of age)
  • Caucasian or Asian
  • Changeable Risk Factors
  • Low dietary intake of calcium
  • Anorexia nervosa or bulimia
  • An inactive lifestyle or lack of exercise
  • Excessive exercise
  • Cigarette smoking
  • Excessive use of alcohol

Other Risk Factors

  • Abnormal absence of menstrual periods (amenorrhea) or skipped periods
  • Surgical menopause, hysterectomy with removal of ovaries
  • Use of certain medications, i.e., corticosteroids, anticonvulsants and drugs to treat endometriosis
  • Low testosterone levels in males

Women can lose up to 20 percent of their bone mass in the 5-7 years following menopause, making them more susceptible to osteoporosis.

White women 60 years of age or older have at least twice the incidence of fractures as African-American women. However, one out of five African-American women is at risk of developing osteoporosis.

Detection of Osteoporosis

Measurement of bone mineral density or bone quality at various sites of the body -- hip, spine, wrist and heels. Bone density tests:

  • Detect osteoporosis before a fracture occurs
  • Predict the chances of fracturing in the future
  • Determine the rate of bone loss and/or monitor the effects of treatment

Prevention of Osteoporosis

Osteoporosis is preventable! Building strong bones, especially before age 35, is the best defense against developing osteoporosis. Maintaining a healthy lifestyle is critical to keeping bones strong. Some tips on preventing osteoporosis:

  • Eat a balanced diet rich in calcium, or take calcium supplements
  • Exercise regularly, using weight-bearing exercises
  • Don't smoke or limit the habit
  • Limit alcohol intake
  • See a doctor if there is a family history of osteoporosis or if monthly periods no longer occur after drug use or surgery

Treatment and Care of Osteoporosis

  • Estrogen, which can be taken orally or as a patch, can prevent the loss of bone mass in postmenopausal women
  • Alendronate, a bisphosphonate, approved by the FDA for the prevention and treatment of osteoporosis, is taken orally and should be monitored for side effects, such as pain in the throat or stomach
  • Calcitonin, which is available by nasal spray and by injection, slows bone breakdown and can reduce the pain associated with osteoporotic fractures
  • Treatments under investigation include other bisphosphonates, sodium fluoride, and selective estrogen receptor modulators, such as drugs that act like tamoxifen -- as both estrogen agonists and antagonists

How To Take Charge of Your Bone Health

Your skeleton is active, living tissue that changes continuously throughout your life. Working like a microscopic demolition crew, some cells continually break down old bone tissue while other cells dash in to build healthy new bone. As long as the breakdown and build-up of bone tissue is equal, your skeleton's infrastructure is in no danger of collapsing. You may, however, have risk factors -- some controllable, some unavoidable -- that slow or inhibit your bone growth. This can eventually lead to osteoporosis, which weakens the skeletal infrastructure, leading to repeated bone fractures.

Discuss osteoporosis with your doctor and his or her health care associates. Ask for appropriate literature and for information about where discussion groups meet.

Despite the fact that osteoporosis may affect one in every two women, three of every four women have never discussed osteoporosis with their doctor. Men rarely discuss the problem with anyone! They may lose bone progressively, without diagnosis, until their spine curves or a fracture occurs.

Know your risk. Studies indicate that bone loss may begin as early as age 25. With a woman's menopause, bone loss can accelerate rapidly with as much as 6 to 10 percent of bone mass being lost in the first year after a woman's periods stop.

Characterized by a gradual deterioration of bone mineral, osteoporosis:

  • Affects 25-35 million Americans, primarily women
  • Causes 1.5 million fractures of the spine, hip and wrist each year
  • May affect one in two women over the age of 65
  • Causes a loss in height, teeth and physical mobility
  • Is more common than diabetes, hypertension or heart disease

While bone loss occasionally may be modified by self-treatment with calcium supplements and dietary and lifestyle changes, (particularly in people who have been on low calcium intakes most of their lives), the amount of bone loss and the speed at which it's being lost can only be detected with precise methods.