February 2000

Osteoporosis

Osteoporosis is a disease, which has received a lot of attention lately in both the medical literature and the lay press. The official definition is a "disease characterized by low bone mass and deterioration of bone tissue leading to bone fragility and increased fracture risk". Most know the disease as affecting primarily elderly women and leading to brittle bones.

Osteoporosis is a major health problem in this country. Twenty-eight million Americans have low bone mass of which 10 million have frank osteoporosis. The main complication of osteoporosis is the development of what are called insufficiency fractures. There are an estimated 1.5 million insufficiency fractures per year. The estimated cost to the U.S. in 1995 was 13.8 billion dollars. There are approximately 250,0000 hip fractures per year of which 65,000 will prove fatal. With a mortality rate of 25% this is greater than most cancers. Hip fractures are the 12th leading cause of death in the U.S.

With such a cost to the health care system and society in general it is no wonder much effort has been paid to finding a cure. We now know the maximum bone mass is reached at about the age of 30. After this the body starts to slowly lose bone mass. More ominous to women is after menopause, without the protective effects of estrogen, the body begins to rapidly lose bone mass. Thus it is imperative to educate teenagers and young adults to eat a diet high in calcium and vitamin D, elements crucial in bone formation, in order to maximize peak bone mass. Once bone mass begins to fall maintaining a healthy diet and lifestyle remain important but strategies to reduce the bone loss or even reverse the process becomes more important. Hormone replacement therapy, estrogen analogs, and anti-bone resorptive agents such as alendronate and calcitonin may be needed. In order to diagnose and adequately treat osteoporosis a reliable way of measuring bone density is needed. The current gold standard is Dual Energy X-ray (DEXA) bone densitometry. Your doctor will be able to answer further questions concerning these issues.

As mentioned earlier, the main complication of osteoporosis is the development of fractures. Strategies to reduce the risk of fractures should receive as much emphasis as those strategies previously mentioned to enhance bone mass. The main cause of fractures, especially in the elderly, is falls. The most dangerous site of falls is the home. It is a cruel irony that our place of refuge may be our primary source of injury. Any tools to reduce the risk of falls and therefore the risk of fracture are helpful. Life at Home has a full line of products designed to make the home a less dangerous place to be. A full range of aids such as grab bars in the bathroom, night-lights, and wheelchair ramps are available. Compared to the cost of hospitalization or even treatment for osteoporosis, these aids are a bargain.

Osteoporosis does deserve the attention it has received. We must educate those who will be susceptible and who are suffering from osteoporosis to ways to maximize their bone density. Since the main complication of osteoporosis is the development of fractures, strategies to minimize the risk of falls may be just as important in maintaining optimal health.

Life@Home staff writer