Half of all American women over 50 years of age will break a bone because of
osteoporosis as well as 1 in 4 men, warned the U.S. Surgeon General. Fracturing the hip or spine often starts a depressing and socially-isolating downward spiral of pain, disability, and deformity for an elderly person. Being immobilized in this way often means losing independence. The consequences can be depressing or even deadly.
As the large “Baby Boom” generation moves beyond 50 years of age, the number of older people with thin and brittle bones is expected to rise sharply. Health care providers are increasingly aware that even more people will be at risk for the limiting and debilitating effects and complications of a broken bone. Focusing on prevention and early detection allows you to make appropriate changes.
Finding out if your bones have become dangerously porous and treating the problem can help reduce your risk of a fracture. An industry-funded study in 2001 estimated that only 12 percent of women 65 years of age or older with osteoporosis or osteopenia (low bone mass) had a Medicare-reimbursed bone marrow density x-ray. Your health care provider now can also use a calculator, called the FRAX tool, to better determine your risk of a hip, wrist, shoulder, or spine fracture after age 40. Available online or on paper, the calculator, developed by the World Health Organization, considers the bone density measurement and nine other risk factors.
The National Osteoporosis Foundation recommends screening adults (men and women) as follows:
- Men older than 70 years should be screened.
- Women older than 65 years of age should be screened.
- Adults who are middle aged and at risk should be screened. (For example, if they have already broken one of their bones as an adult, have a family history of osteoporosis or broken bones, use tobacco, or weigh less than 127 pounds.)
Older women benefit the most from screening for osteoporosis, experts tend to think. Prevention efforts ideally begin in adolescence and young adulthood. After menopause, women need to be on the lookout for brittle bones and their susceptibility to fracture. Many government and medical organizations agree on the following:
- Women 65 years of age and older should have their bone mass measured.
Screening after menopause is also appropriate for some younger women:
- Younger women who have gone through menopause (which usually occurs between 45 to 55 years of age) and are at risk of a fracture due to porous bone benefit from screening.
Note that taking certain medications or having certain medical and physical conditions adds to your risk. Your health care provider can assess your risk and advise you on exercise and balance training, how to get the calcium your bones need, and ways to avoid smoking and appropriately limit your alcohol consumption. These steps help slow the loss of bone mass that occurs with aging.
How long to wait before getting re-tested hasn’t been firmly established, but how dense your bones are may be a factor. The National Osteoporosis Foundation says re-testing is usually done after 2 years. Ask your health care provider for current information.
Links
National Institutes of Health Osteoporosis and Related Bone Diseases: Check Up On Your Bones
National Osteoporosis Foundation: Bone Tool Kit
Sources
US Department of Health and Human Services. Bone health and osteoporosis: a report of the surgeon general (2004). Available on the Internet at http://www.surgeongeneral.gov/library/bonehealth through http://www.surgeongeneral.gov. Accessed 19 Feb 2008.
National Osteoporosis Foundation. Bone tool kit. 2007. PDF available for download at http://www.nof.org/awareness2/2007/images/Bone_Tool_Kit.pdf through http://www.nof.org. Accessed 19 Feb 2008.
California Department of Health Services Osteoporosis Prevention and Education Program, Chronic Disease Control Branch. California’s action plan to prevent osteoporosis: 2005-2015. Available on the Internet at http://www.dhs.ca.gov/CDIC/cdcb/Medicine/Gerontology/OAUnit through http://www.dhs.ca.gov. Accessed 20 Feb 2008.
National Osteoporosis Foundation. Clinician’s guide to prevention and treatment of osteoporosis. 2008. Available on the Internet at http://www.nof.org/professionals/Clinicians_Guide.htm through http://www.nof.org. Accessed 26 Feb 2008.
World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, United Kingdom. FRAX WHO fracture risk assessment tool. Available on the Internet at http://www.shef.ac.uk/FRAX. Accessed 26 Feb 2008.
National Osteoporosis Foundation. Physician’s guide to prevention and treatment of osteoporosis. 2003. Available on the Internet at http://www.nof.org/physguide through http://www.nof.org. Accessed 19 Feb 2008.
Raisz, LG. 14 Jul 2005. Screening for Osteoporosis. N Engl J Med 353;2:164-171. PDF available for download at http://www.temple.edu/iimreports/ReadingList/Miscscreening-for-Osteoporosis-NEJM-2005.pdf through http://www.temple.edu. Accessed 13 Mar 2008.
Berg AO, for the US Preventive Services Task Force. Screening for osteoporosis in postmenopausal women: recommendations and rationale. Jan 2003. Am J Nursing 103(1):73-80. Available on the Internet through http://www.guideline.gov. Accessed 19 Jul 2004 and 19 Feb 2008.
National Osteoporosis Foundation. NOF applauds USPSTF recommendation on BMD tests (press release). 16 Sep 2002. Previously available on the Internet at http://www.nof.org/news/pressreleases/uspstf_02.html. Accessed 19 Jul 2004; document no longer posted.
