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Osteoporosis the second largest public health problem

According to the World Health Organization, osteoporosis is now considered the second largest public health problem for women. It is estimated that the disease affects nearly 40% of women over age fifty. Many countries including the United States have reported that approximately one in three women over the age of fifty will have an osteoporotic fracture in her lifetime. Men are not immune: the lifetime risk of having a fracture in a 60 year old man is about 25%. Men are about half as likely to sustain a hip fracture as women but, because women live longer, about 80% of hip fractures occur in women.

  • In the United States, 10 million Americans have been diagnosed with osteoporosis and another 18 million are at risk for developing the disease because they have decreased bone mass
  • There are approximately 250,000 hip fractures and 700,000 vertebral fractures in this country each year
  • Whites have a higher rate of hip fracture than nonwhites. Rates in Asian populations have been reported as being between the two groups
  • Up to 25% of people having a hip fracture may need long-term nursing home care
  • The direct cost for treatment of osteoporotic fractures in the United States was an estimated $13.8 billion in 1995. Fracture numbers continue to rise as the population ages
  • Mortality rates in the first year after hip fracture has been reported to be between 10 to 20% higher than in people the same age and health condition who don't have a fracture

What are the symptoms of osteoporosis?

At the beginning, osteoporosis causes no symptoms, but later it can lead to serious problems such as:

  • Back pain
  • Loss of height and stooped posture
  • Bone fractures

Osteoporosis is a condition resulting from the loss of bone. This disease process makes bone fragile and likely to fracture. Common sites for osteoporotic fractures include the spine, hip and wrist. Fractures of the spine (vertebra) lead to the typical round-shouldered appearance (sometimes called a dowagers hump) that may be associated with back pain and height loss.

It is estimated that a postmenopausal woman has a 30% chance of developing an osteoporotic fracture during her lifetime. A woman's lifetime risk of hip fractures is equal to the combined risk of developing breast, uterine, and ovarian cancer. Woman who sustain hip fractures have been reported to have an increased mortality of up to 20% in one year.

 

What factors can affect risk for osteoporosis?

While many factors should be considered in evaluating osteoporosis, patients and practitioners should pay attention to the following risk factors, both those which can and cannot be changed.

Non-Modifiable Risk Factor (things which cannot be changed)

  • Personal history of fracture as an adult
  • History of fracture in first-degree relative (brother, sister or parent)
  • History of fracture as an adult (especially low trauma)
  • Advanced age
  • Being female
  • Dementia (Alzheimers)
  • Poor health or frailty
  • Caucasian, Asian or Hispanic ethnicity
  • Thin or small build
  • Family history of osteoporosis or osteoporotic fracture
  • History of hyperparathyroidism or hyperthyroidism
  • Early menopause (before age 45) or surgical menopause

Modifiable Risk Factors (things which can be changed)

  • Current cigarette smoking
  • Low body weight (under 125 pounds)
  • Estrogen deficiency
  • Premenopausal amenorrhea
  • Low calcium intake (lifelong)
  • Alcoholism
  • Impaired eyesight despite adequate correction
  • Recent falls
  • Inadequate activity or sedentary lifestyle
  • Use of certain medications such as steroids or anticonvulsants

Age, personal or family history of fracture, Caucasian ethnicity, tobacco use, low body weight, cortisone use, and early menopause are associated with significantly increased likelihood of osteoporosis. Higher body mass index, African-American heritage, estrogen or diuretic use, and exercise significantly decrease the chances of developing the disease. The presence or absence of any of these factors, however, does not assure immunity or automatically result in osteoporosis.  

Osteoporosis is a disease in which bones become fragile and more likely to break. If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These broken bones, also known as fractures, occur typically in the hip, spine, and wrist.

Any bone can be affected, but of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalization and major surgery. It can impair a person's ability to walk unassisted and may cause prolonged or permanent disability or even death. Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, and deformity.

For more information about osteoporosis go to, www.iscd.org

 

 

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Last modified: 08/29/07