What is osteoporosis?
Osteoporosis, or porous bone, is a disease characterized by low bone mass and deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures, especially of the hip, spine and wrist, although any bone can be affected.
The National Osteoporosis Foundation recommends the following five steps for optimizing bone health and helping prevent osteoporosis:
- Get the daily recommended amounts of calcium and vitamin D
- Engage in regular weight-bearing and muscle-strengthening exercise
- Avoid smoking and excessive alcohol
- Talk to your health care provider about bone health
- Have a bone density test and take medication when appropriate
- In the U.S. today, 10 million individuals are estimated to already have the disease and almost 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis.
- Osteoporosis is a major public health threat for an estimated 44 million Americans, or 55 percent of the people 50 years of age and older.
- While osteoporosis is often thought of as an older person’s disease, it can strike at any age.
- Eighty percent of those affected by osteoporosis are women and 20 percent of those affected are men.
- Significant risk has been reported in people of all ethnic backgrounds.
- Osteoporosis is under recognized and under-treated not only in Caucasian women, but in African-American women as well.
- People cannot feel their bones getting weaker. They may not know that they have osteoporosis until they break a bone. A person with osteoporosis can fracture a bone from a minor fall, or in serious cases, from a simple action such as a sneeze or even spontaneously.
- Vertebral (spinal) fractures may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis or stooped posture. In many cases, a vertebral facture can even occur with no pain.
Who is at risk?
Certain people are more likely to develop osteoporosis than others. Risk factors include:
- Being female
- Older age
- Family history of osteoporosis or broken bones
- Being small and thin
- History of broken bones
- Low sex hormones
- Low estrogen levels in women, including menopause
- Missing periods (amenorrhea)
- Low levels of testosterone and estrogen in men
- Low calcium intake
- Low vitamin D intake
- Excessive intake of protein, sodium and caffeine
- Inactive lifestyle
- Smoking and excessive alcohol intake (three or more drinks a day)
- Certain medications such as steroid medications, some anticonvulsants and others
- Certain diseases and conditions such as anorexia nervosa, rheumatoid arthritis, gastrointestinal diseases and others
Bone density tests can measure bone density in various sites of the body. Experts recommend a type of BMD test using a central dual energy x-ray absorptiometry or DXA. A bone density test performed by a central DXA can:
- Determine if a person has low bone density before a fracture occurs
- Determine if a person’s bones are losing bone density or staying the same when the test is repeated annually
- Predict the chances that a person will have a fracture in the future
- Help you and your patient decide if treatment is needed
How often should bone density testing be done?
People taking an osteoporosis medication should repeat their BMD test by central DXA every two years, according to the National Osteoporosis Foundation (NOF). Some health care providers may have certain patients repeat their BMD test after one year. Medicare reimburses for BMD testing every two years.