Question: I am
a 75-year-old woman in excellent health. My 78-year-old
sister told me she was recently diagnosed with osteoporosis.
What is osteoporosis? Am I at risk? Should I be tested for
osteoporosis?
Answer:
Osteoporosis is a disease characterized by thinning and
weakening of the bones. Bones have two kinds of cells: one
type builds new bone, the other breaks down old, worn-out
bone. Until age 30, we MAKE more bone than we break down.
After age 30, however, we BREAK DOWN more bone every day
than we make, leading to a loss of bone density as we age.
In some people, this bone loss becomes so significant that
the bone is not strong enough to withstand stress, and is at
risk for fractures. This is OSTEOPOROSIS. Even a small
stress, such as a fall, step down a stair or minor bump
could fracture an osteoporosis bone.
Since we lose bone daily after age 30, AGE is the main risk
factor for osteoporosis. ANYONE can develop osteoporosis if
they live long enough! However, there are several other
important risk factors. WOMEN are at higher risk than men
for two reasons: 1) women live longer on average, and are
smaller than men (lower peak bone density at age 30). 2)
women experience an ACCELERATED RATE of bone loss for about
5-8 years after menopause, then return to the prior rate.
Unfortunately, this period of rapid loss may put a woman on
the verge of osteoporosis.
Other risk factors include:
WHITE OR ASIAN RACE
LOW BODY WEIGHT AND SMALL FRAME
FAMILY HISTORY OF OSTEOPOROSIS
EARLY MENOPUASE
KIDNEY, THYROID OR PARATHYROID DISEASE
USE OF STEROID OR ANTI-SEIZURE MEDS
Obviously, we can’t control the above risk factors. We CAN
control the following serious risk factors:
ALCOHOL USE
SEDENTARY LIFESTYLE
INADEQUATE CALCIUM
SMOKING
The National Institutes of Health Consensus Panel on
Osteoporosis Prevention, Diagnosis and Treatment now
recommends that all women over the age of 65 and men over
the age of 70 be tested for osteoporosis. Additionally,
women over age 50 with one or more risk factors, and men
over 50 with 2 or more risk factors should be tested.
Testing is done via BONE MINERAL DENSITOMETRY. This is a
type of x-ray that measures the density of the bone in
various sites, most often the hip and spine. This density is
compared to the average value for a normal young adult of
the same gender. Values of bone density that are more than 2
levels lower than average are diagnostic of osteoporosis,
and treatment should be discussed with your doctor and
begun. Values 1-2 levels lower than average are known as
OSTEOPENIA. This person is at risk for osteoporosis in the
near future. Depending on the situation, osteoporosis
treatment may also be necessary. |
