Osteoporosis, the silent disease
Each year the risk of having a fracture due to osteoporosis is greater than the combined risk of suffering from a heart attack, stroke, or breast cancer.
Much has been reported about the devastating impact of cancer and heart disease on the aging population, but there is a silent disease called osteoporosis, the impact of which affects every aspect of day-to-day living. Ten million people have osteoporosis, three million have a low bone mass, and 40% or more women will suffer an osteoporosis related fracture in their lifetime. Each year the risk of having a fracture due to osteoporosis is greater than the combined risk of suffering from a heart attack, stroke, or breast cancer.
Osteoporosis is a condition that causes bones to become less dense; hence they become weak and fracture easily. The condition affects the entire skeleton, but the majority of osteoporotic fractures occur in the spine, hip, and wrist. More than two thirds of the fractures occur without any warning symptoms. Those who are advancing in age are more prone to osteoporosis. Other factors include gender, (particularly females after menopause), inactive lifestyle, cigarette smoking, being of Caucasian or Asian descent, consuming poor or inadequate calcium, and taking certain medications such as steroids. Family history is also important because there is evidence of genetic predisposition. It is important to note that elderly men can also have osteoporosis and suffer the same consequences as women.
Risk factors for osteoporosis can be modified by lifestyle changes such as weight loss, exercise, smoking cessation, and supplementation with calcium and Vitamin D.
If you are at risk of developing osteoporosis, the simplest test is a Bone Mineral Density test with a DEXA scan, which tests the bone density in the hip and spine and compares it to that of a young adult of the same gender. The number obtained is called a T-score. A T-score of greater than –1.0 is normal; one between –1.0 and –2.5 is called osteopenia or thin bones, and a T-score of less than or equal to –2.5 is osteoporosis. There are some other methods of measuring bone density such as the peripheral scan that checks the bone density in the ankle or hand. These are just screening tools and can indicate possible osteoporosis, but are not as accurate as the DEXA test. The National Osteoporosis Foundation recommends that all women over the age of 65 have a DEXA scan, as well as women with a history of fracture, or at least one risk factor for osteoporosis. Any adult on medications, or with a disease such as certain thyroid disorders that cause bone loss should also have a DEXA scan.
If you are diagnosed with osteoporosis, your doctor may discuss treatment options. There are certain drugs that aid in new bone growth such as alendronate and residronate; there are some hormonal preparations that help new bone formation called Raloxifen; and there is a nasal spray called calcitonin. Estrogen was used widely to prevent osteoporosis in postmenopausal women but is seldom used now because of potential increased risk of heart disease. There is also an injectable preparation available now called Teriparatide, which is a daily shot that aids in bone growth. Your physician is the best person to determine which medication is right for you.
It is important to be aware of this silent disease because, despite being so prevalent, it can be easily prevented, diagnosed, and treated.
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"Osteoporosis, the silent disease"
authored by:
Dr. Pandita received her medical degree from Christian Medical College, Vellore, India. She completed a residency in internal medicine at University of North Dakota affiliated hospitals including MeritCare Health System and the Veterans Administratio...
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