Bone Health is Important for All Ages
by Ngozi Osuagwu, MD | August 28th, 2022
Every year I have to read a certain amount of articles to maintain my board certification for obstetrics and gynecology. This weekend, I read the American College of Obstetricians and Gynecologists report titled Osteoporosis Prevention, Screening, and Diagnosis.
Osteoporosis is serious and even deadly. Osteoporosis is a condition in which the bones become weak and brittle. Osteoporosis is common. Most people with osteoporosis do not know they have it until a fracture occurs. One in two women over 50 will break a bone due to osteoporosis. Unfortunately, only 24% of women aged 60 and older receive osteoporosis treatment during the first year after a fracture.
Each year in the U.S., approximately 300,000 hip fractures usually occur after a fall. About 75,000 Americans who experience a hip fracture die in the year following the hip fracture. Another 75,000 Americans move from the hospital to a nursing home and never return “home.” The remaining 150,000 Americans never regain their previous function. Six months after a hip fracture, only 15 percent of patients can walk across a room unaided.
In the United States, the prevalence of osteoporotic fracture varies by race, with the highest rates reported among White and Hispanic populations, followed by Native Americans, Asians, and Black populations. There exist health inequities in each step of osteoporosis care:
- Black and Hispanic women are less likely than White women to undergo dual-energy X-ray absorptiometry (DXA) after a hip fracture.
- Black women with osteoporosis were significantly less likely to receive treatment than White and Hispanic women.
- After a fragility fracture, Black women are more likely to die within one year when compared with White women.
Bone health is important for all ages. Osteoporosis is treatable, if not preventable. The National Osteoporosis Foundation has created a free downloadable resource tool titled 35 Ways to Stay Bone Strong. All women and men can start where they are to get their bones strong.
A checklist is provided to help you remember to get your questions answered and make the most of your visit with your healthcare provider. I downloaded the questions and want to try to answer some. This is not to stop you from asking your physician the questions.
- Do I have risk factors for osteoporosis or fractures? Risk factors include getting older, smoking, excessive alcohol abuse (more than three drinks per day), a body weight of fewer than 127 pounds, family history of hip fracture, certain medications, and certain health conditions.
- Trying to get most of your calcium through diet would be best. Am I getting enough calcium and vitamin D? You should be getting 1,000 mg per day of calcium from ages 19 to 50 years and 1,200 mg per day if you are older. For Vitamin D, 600 international units per day to age 70 and 800 international units older than 70. Most studies have not shown that calcium and vitamin D will prevent fractures, but they will help with overall bone health.
- What kind of exercise can help me build strong bones? Be physically active every day. Weight-bearing exercise (for example, fast walking, hiking, jogging, and weight training) may strengthen bones and slow the rate of bone loss than comes with aging. Balancing and muscle-strengthening exercises can reduce the risk of falling and fractures.
- Could any medications I take cause bone loss? The steroids you take for asthma, medicines for thyroid disease, drugs for epilepsy, and chemotherapy, to name a few, can cause bone loss. Review your medicine list with your health care provider.
- Do I have medical conditions that could increase my risk of bone loss? Examples include hyperthyroidism, rheumatoid arthritis, diabetes (type 1 and type 2), gastric bypass, and premature menopause.
- Do I need a bone mineral density (BMD) test? The bone mineral density test is called the dual-energy X-ray absorptiometry (DXA). The recommendation is for all postmenopausal aged 65 and older to be screened for osteoporosis with DXA. You may be screened at an earlier age if you have risk factors.
- Are my BMD results normal? Anytime a test is done, find out when to expect the results and talk with your doctor. If the BMD is abnormal, discuss the various available medications with your doctor. If your provider feels uncomfortable treating you, then you can ask for a referral to a physician who specializes in treating osteoporosis.
- How often should I get a DXA? If your DXA is normal, you can be screened every 4 –8 years. If your DXA is abnormal, you will probably be screened every two years.
- How do I prevent falls? Make sure that you eliminate things in your environment that can contribute to falls. Make sure there is ample lighting in the house. Use nonskid rugs on the floor: placemats or grab bars in the shower. Get an eye exam. If you cannot see well, you may trip and fall.
- Where can I learn more information about osteoporosis? You can go to the Bone Health and Osteoporosis Foundation.
Sources:
American College of Obstetricians and Gynecologists. Osteoporosis Prevention, Screening, and Diagnosis. Obstet Gynecol 2021;138:494 -506
National Osteoporosis Foundation
Excellent, excellent, excellent information which has broadened my health knowledge base. Thank you so very much!!!!!
Please continue to share the information so more people can learn.
Thanks for passing on your knowledge. I knew some of this but not all, and I have a family history of osteoporosis
Please continue to share the information so many more can benefit.