Over the last several decades, improvements in medical care and disease prevention have vastly increased life expectancy, yet osteoporosis remains an under-diagnosed and under-treated condition. This is particularly alarming given that osteoporosis is a progressive disease – it gets increasingly worse without intervention.
According to national health estimates, half of all women and 20 percent of all men will have an osteoporotic fracture in their lifetime. Each year, more than 2 million osteoporotic fractures occur in the United States. In the year 2000, osteoporosis is estimated to have caused 36,630 bone fractures in New Jersey alone.
Though osteoporosis usually is thought of as an older person’s disease, it can strike at any age. The outlook for persons experiencing a hip fracture is particularly alarming:
- 20 percent of hip-fracture patients may require long-term nursing home care.
- 50 percent never regain their ability to walk independently, and up to 20 percent die within one year due to complications of the fracture or accompanying surgery.
- Approximately 33 percent of people are totally dependent following hip fracture.
Women Versus Men
Osteoporosis is not a gender-specific disease. Although it frequently is thought of as a ‘woman’s disease,’ osteoporosis has been diagnosed in nearly 2 million American men, and that number is expected to increase by nearly 20 percent by the year 2015.
Further statistics show that 20 percent of all osteoporotic fractures and 30 percent of all hip fractures in the United States occur in men, with outcomes worse in men than in women. The one-year mortality rate following hip fracture is 30 percent in men versus 20 percent in women; vertebral fractures cause higher mortality in men than in women; and the institutionalization rate after fracture is higher in men than in women.
The most significant risk factors that lead to osteoporosis in men are a family history of osteoporosis, advanced age, smoking, alcohol abuse, certain medical conditions and low levels of testosterone. Despite the large number of men affected, osteoporosis in men remains under-diagnosed, under-reported, and inadequately researched.
New Initiatives in Diagnosis and Management
Modeled on the American Orthopaedic Association’s “Own the Bone” bone health initiative, Cooper’s new Fragility Center offers comprehensive care to improve the diagnosis and management of patients with fragility fractures. Part of Cooper’s respected Bone and Joint Institute, the Fragility Center is the first and only program of its kind in South Jersey, offering access to the full range of sub-specialists involved in screening for and treating osteoporosis – the leading cause of fragility fractures.
“’Own the Bone’ is a clinically proven quality-improvement program designed to identify, evaluate and initiate evidence-based care in fragility fracture patients age 50 and over,” said orthopedic surgeon Paul M. Lafferty, MD. “Our goal at Cooper is to close the treatment gap between repair of fragility fracture and preventing future fractures via a comprehensive, multidisciplinary approach.”
Osteoporosis is both preventable and treatable. Steps can be taken at any age to prevent or minimize the effect of osteoporosis. The key to preventing osteoporosis is to eat calcium-rich foods and increase physical activity by doing weight-bearing or resistance exercises to build bone mass. Your risk of developing osteoporosis depends on the amount of bone mass built through age 35.
Eating foods high in calcium and vitamin D provides the building blocks your body requires to maintain good bone mineral density. Vitamin D deficiency is very common among older individuals but may not be apparent from laboratory reference ranges of serum calcium and phosphate. Thus, individuals may need to be tested for vitamin D deficiency by measuring levels of 25-hydroxy-vitamin D. Vitamin D and calcium supplementation is encouraged for all individuals, especially those over the age of 50.
Exercise is also important. Activities where the bones must hold the body up against gravity, such as walking and jogging, help maintain strong bones. However, this alone is not enough to stimulate the building of bone mass in highly sensitive areas, such as spine and hip. Weight bearing exercises are extremely important for osteoporosis prevention and treatment. Activity can be performed with weights or stretch bands. As muscle strength is gained, weights or resistance (less stretchy) is increased. This type of exercise stimulates bone to increase bone mineral density. Maintaining a healthy lifestyle by limiting alcohol intake and avoiding smoking is also important.
Full Team Effort Concerned With Osteoporosis
Effective management of osteoporosis often requires a team approach. Dieticians, endocrinologists, family practitioners, geriatricians, gynecologists, internists, occupational therapists, orthopedic surgeons, pharmacists, physiatrists, physical therapists and rheumatologists all may have a role to play in managing your osteoporosis, depending on the clinical situation. All these services are available through Cooper University Hospital.
Speak With Your Physician
We encourage you to speak with your doctor about specific steps to take to help keep your bones strong, to prevent or treat osteoporosis, and to prevent fragility fractures.