Communications: Patient Education

Patient Education: Maintaining Bone Health as You Age

Sunday, November 23, 2008  
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As people get older, their bones can become thin and lose mass. This can lead to a very common and serious disease called osteoporosis. Over time, the disease causes bones to weaken and break easily.

"Millions of Americans have osteoporosis,” said Christine Albrecht, a family physician with Lakewood Health System in Staples, Minnesota. "If not prevented or treated, fractures of the hip, spine, and wrist commonly occur.”

According to the National Institute of Health, more than 1.5 million people each year in the United States suffer an osteoporosis-related fracture. Dr. Albrecht says that patients who suffer a hip fracture almost always require a major surgery and encounter a prolonged recovery period. Many people never walk independently after a breaking their hip. Statistics show more than one in five will die within a year after the fracture and the same number end up in a nursing home. Patients who fracture their spine experience severe pain and even loss of height.

Although women are four times more likely to develop osteoporosis than men, the disease is not limited to that gender. "For many years, osteoporosis was thought of as a women’s disease, but that’s definitely not true,” said Dr. Albrecht. "As our population continues to grow older, we are seeing many more men with osteoporosis and unfortunately men who suffer an osteoporosis-related fracture are twice as likely to die from it than women.”

Osteoporosis is often called the "silent disease” because bone loss occurs without any symptoms. The best way to determine your bone health is to have a screening using a dual-energy x-ray absorptiometry, or DXA. It is a painless type of x-ray that looks at both hip and spine bone density. A DXA scan report will show normal bone health, osteopenia, or osteoporosis. Osteopenia means that bones are becoming weak, but are not fragile enough to be considered osteoporosis.

Screening should take place at age 65 for otherwise healthy women. According to the National Osteoporosis Foundation (NOF), men age 70 and older should also have their bone mineral density tested. Patients who have certain risk factors should talk to their family physician about being screened earlier. Those risk factors include being thin or small- boned, being of the Caucasian or Asian race, those who smoke cigarettes, those with a low dietary calcium intake, women who experience early menopause, those have used steroids for a long period, those who have lost height or had previous low trauma fractures.

While there is no cure for osteoporosis, the good news is that the disease is largely preventable. To do this, bone health needs to be maximized by getting enough regular weight bearing exercise, by quitting smoking, and by getting adequate amounts of calcium and vitamin D.

Getting the daily recommended amount of calcium, whether through diet, supplements, or combination, is essential to maintaining bone strength and can play a vital role in preventing osteoporosis-related fractures. According to NOF recommendations, adults under age 50 need 1,000 mg of calcium daily, and adults age 50 and over need 1,200 mg of calcium daily.

Vitamin D
Vitamin D plays a major role in calcium absorption and bone health. Adults under age 50 need 400-800 IU of vitamin D daily, and adults age 50 and older need 800 – 1,000 IU of vitamin D daily. Vitamin D can also be obtained from fortified milk, egg yolks, saltwater fish, liver and supplements. It can also be made through skin with sunlight exposure; however, the sun is not strong enough many months out of the year in Minnesota to make vitamin D.

"It is still very important for a person who has been diagnosed with osteoporosis to get enough exercise, calcium and Vitamin D to prevent the disease from worsening,” Dr. Albrecht said. "There are several treatments available now, including oral IV and injectable medication. A patient should talk with his or her family physician to find the best treatment plan.”

The Minnesota Academy of Family Physicians is a professional association of approximately 3,000 family physicians, family medicine residents and medical students organized to assist family physicians in providing quality medical care in Minnesota. The MAFP is the largest medical specialty organization in Minnesota and is a state chapter of the American Academy of Family Physicians, one of the largest national medical organizations in the United States with more than 103,000 members.

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