Osteoporosis (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Catherine Burt Driver, MD
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
In this Article
- Osteoporosis facts
- What is osteoporosis?
- What are osteoporosis symptoms and signs?
- What are the consequences of osteoporosis?
- Why is osteoporosis an important public health issue?
- What factors determine bone strength?
- What are osteoporosis risk factors and causes?
- How is osteoporosis diagnosed?
- Who should have bone density testing?
- What is the treatment for osteoporosis, and can osteoporosis be prevented?
- Exercise, quitting cigarettes, and curtailing alcohol
- Calcium supplements
- Vitamin D
- Hormone therapy (hormone replacement therapy, menopausal replacement therapy)
- Medications that prevent bone loss and breakdown
- Choosing an osteoporosis medication
- Prevention of osteoporosis caused by long-term corticosteroids
- Monitoring osteoporosis therapy medication
- Prevention of hip fractures in elderly people with osteoporosis
- What are complications of osteoporosis?
- What is the prognosis (outlook) for patients with osteoporosis?
- Osteoporosis FAQs
- Find a local Internist in your town
Why is osteoporosis an important public-health issue?
- In the U.S., 44 million people have low bone density (10 million have osteoporosis, and 34 million have osteopenia). This amounts to 55% of the U.S. population aged 50 years and older.
- One in two Caucasian women will fracture a bone due to osteoporosis in her lifetime.
- In the U.S., direct health-care costs from osteoporosis fractures amount to a billion dollars, without even taking into account the indirect costs, such as lost days at work and productivity.
- Approximately 20% of those who experience a hip fracture will die in the year following the fracture.
- One-third of hip-fracture patients are discharged to a nursing home within the year after fracture.
- Only one-third of hip-fracture patients regain their pre-fracture level of function.
With the aging of America, the number of people with osteoporosis-related fractures will increase exponentially. The pain, suffering, and overall impact on health and economic costs will be enormous.
What factors determine bone strength?
Bone mass (bone density) is determined by the amount of bone present in the skeletal structure. Generally, the higher the bone density, the stronger the bones. Bone density is greatly influenced by genetic factors, which in turn are sometimes modified by environmental factors and medications. For example, men have a higher bone density than women, and African Americans have a higher bone density than Caucasian or Asian Americans.
Normally, bone density accumulates during childhood and reaches a peak by around age 25. Bone density then is maintained for about 10 years. After age 35, both men and women will normally lose 0.3%-0.5% of their bone density per year as part of the aging process.
Estrogen is important in maintaining bone density in women. When estrogen levels drop after menopause, loss of bone density accelerates. During the first five to 10 years after menopause, women can suffer up to 2%-4% loss of bone density per year! This can result in the loss of up to 25%-30% of their bone density during that time period. The accelerated bone loss after menopause is a major cause of osteoporosis in women, referred to as postmenopausal osteoporosis.
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