osteoporosis: one of 10 million?

Osteoporosis literally means porous bone, and is a common disease in older individuals. It is characterized by too little bone formation, excessive bone loss, or a combination of both, leading to bone fragility and an increased risk of fractures of the hip, spine and wrist. Most people do not realize they have it until they either have a fracture or they get a bone mineral density test. People over the age of 70 are more likely to have low bone density.

Prevalence and Risk
Osteoporosis develops when a large amount of our spongy bone tissue breaks down, leaving bigger spaces. The bone then becomes more porous and brittle. The disease impacts nearly 10 million Americans with four times as many at risk for this illness according to the National Health and Nutrition Examination Survey III. Osteoporosis affects men and women of all races. But white and Asian women — especially women who are post-menopausal — are at highest risk. It is estimated that there is up to a 36% increase in death in the first year after a hip fracture. Despite this frightening statistic, only 23% of women age 67 or older who have an osteoporosis-related fracture are prescribed a medication or a bone density test to evaluate the extent of the illness within six months. So talk to your doctor about symptoms and getting evaluated.

Bisphosphonates: An Effective Treatment
The good news is that there are many treatments that are effective for osteoporosis. Bisphosphonates are a common class of medications that slow the rate at which the body breaks down bone and can decrease your risk of fracture by up to 70% in some cases. The rare side effects associated with these medications include osteonecrosis of the jaw (a bone disease that causes pain, swelling or infection in the jaw) and atypical fractures. However, for every 100,000 women taking a bisphosphonate, fewer than three will have osteonecrosis of the jaw, and one will have an atypical femur fracture. The good news is that 2,000 will have avoided an osteoporotic fracture. Compared with many other common diseases, we are fortunate that we have good therapies to reduce the risk of osteoporotic fractures by 70% at the spine and 40 to 50% at the hip. If bisphosphonates are not the best medication for you, there are other options. It is essential to discuss this with your doctor.

Prevention
There are several things you can do to protect your bones and lower your risk of developing osteoporosis. These include eating a diet rich in calcium, getting regular exercise, avoiding alcohol and quitting smoking. Making sure your body has enough vitamin D is also important. Dietary supplements can be used as an additional source of calcium and vitamin D if you are not getting enough in your diet. Additionally, it is important to exercise. Combine strength training with weight-bearing and balance exercises. Strength training helps strengthen muscles and bones in your arms and upper spine; and weight-bearing exercises — such as walking, jogging, running, stair climbing, skipping rope — affect mainly the bones in your legs, hips and lower spine. Balance exercises such as tai chi can reduce your risk of falling, especially as you get older. Be strong and be healthy!

Caroline DeFilippo, M.D.

Caroline DeFilippo, M.D.

Caroline DeFilippo, MD, MPH, is Assistant Medical Director and a practicing internist at CareMount Medical.She sees patients in Mount Kisco. Board Certified in Internal Medicine, she graduated from Harvard University with a Bachelor of Arts degree in Environmental Studies and Public Policy. She received her Doctor of Medicine and Master of Public Health from the Icahn School of Medicine at Mount Sinai. www.caremountmedical.com
Caroline DeFilippo, M.D.

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