Fast Facts on Osteoporosis

Definition
Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fracture of the hip, spine and wrist.

Prevalence
Osteoporosis is a major public health threat for more than 28 million Americans, 80 percent of whom are women, according to the National Osteoporosis Foundation. In the U.S. today, 10 million individuals already have the bone disease and 18 million more have low bone mass, placing them at increased risk for osteoporosis. 80 percent of those affected by osteoporosis are women. One out of every two women and one in eight men over age 50 will have an osteoporosis-related fracture in their lifetimes. By age 75, one-third of all men are affected by osteoporosis. While osteoporosis is often thought of as an older person's disease, it can strike at any age. Osteoporosis is responsible for 1.5 million fractures annually, including:

• More than 300,000 hip fractures
• 700,000 vertebral fractures
• 200,000 wrist fractures
• More than 300,000 fractures at other sites.

Cost
The estimated national direct expenditures (hospitals and nursing homes) for osteoporosis and associated fractures is $13.8 billion ($38 million each day) -- and the cost is rising.

Symptoms
Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump or fall causes a fracture or a vertebra to collapse. Collapsed vertebrae 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.

Risk factors
Certain people are more likely to develop osteoporosis than others. Factors that increase the likelihood of developing osteoporosis are called risk factors. The following risk factors have been identified:

Women can lose up to 20 percent of their bone mass in the five to seven years following menopause, making them more susceptible to osteoporosis.

However, two million American men are affected by osteoporosis and one out of eight men age 50 and older will develop fractures. White women 60 years of age or older have at least twice the incidence of fractures as African-American women. However, one out of five African-America women are at risk of developing osteoporosis.

Detection
Specialized tests called bone density tests can measure bone density in various sites of the body. A bone density test can:

• Detect osteoporosis before a fracture occurs
• Predict your chances of fracturing in the future
• Determine your rate of bone loss and/or monitor the effects of treatment if the test is conducted at intervals of a year or more.

Prevention
Building strong bones, especially before the age of 35, can be the best defense against developing osteoporosis, and a healthy lifestyle can be critically important for keeping bones strong. So to help prevent osteoporosis:

• Eat a balanced diet rich in calcium
• Exercise regularly, especially weight-bearing activities
• Don't smoke and limit alcohol intake
• Talk to your doctor if you have a family history of osteoporosis or no longer have the protective benefit of estrogen due to natural or surgically-induced menopause.

Fractures
The most typical sites of fractures related to osteoporosis are the hip, spine, wrist and ribs, although the disease can affect any bone in the body. Forty percent of all women will have at least one spinal fracture by the time they reach age 80. Spinal osteoporosis is eight times more likely to afflict women than men.

The rate of hip fractures is two to three times higher in women than men; however, the death rate of men within one year after a hip fracture is 26 percent higher than that in women. A woman's risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancer.

In 1991, about 300,000 Americans age 45 and over were admitted to hospitals with hip fractures. Osteoporosis was the underlying cause of most of these injuries. Individuals suffering hip fractures have a 5 to 20 percent greater risk of dying within the first year following that injury than others in their age group. Among those who were living independently prior to a hip fracture, 15 to 25 percent are still in long-term care institutions a year after the injury.

Treatment & Care
Although there is no cure, treatments are available to help stop further bone loss and fractures:

• Studies have shown that estrogen can prevent loss of bone mass in postmenopausal women.
• Alendronate, a bisphosphonate, recently has been approved by the Food and Drug Administration for treatment of postmenopausal osteoporosis.
• Calcitonin is another treatment used by both women and men for osteoporosis. This drug has been shown to slow bone breakdown and also can reduce the pain associated with osteoporosis fractures.
• Treatment under investigation include other bisphosphonates, sodium fluoride, vitamin D metabolites and selective estrogen receptor modulators.

Medical experts agree that osteoporosis is highly preventable. However, if the toll of osteoporosis is to be reduced, the commitment to osteoporosis research must be significantly increased. It is reasonable to project that with increased research, the future for definitive treatment and prevention of osteoporosis is very bright.

References:

National Osteoporosis Foundation, 1997

The National Osteoporosis Foundation is the nation's leading resource for patients, health care professionals, and organization seeking current, medically sound information on the causes, prevention, diagnosis and treatment of osteoporosis. For more information, please contact: National Osteoporosis Foundation, 1150 17th Street, NW, Suite 500, Washington, DC 20036, 202-223-2226, fax 202/223-2237.