"Osteoporosis—the Silent Crippler" By Allen Weiss, MD, MBA, President and CEO

Osteoporosis - The Silent Killer

May 1, 2010 - Mother’s Day is May 9 and I’d like to share a “present” with all moms, and all the rest of us who honor the women in our lives. This “present” is to help those we want to care for and protect against the ravages of osteoporosis. We can do this by first understanding the disease and then engaging in preventive measures.

Osteoporosis is a disease which discriminates against women. One half of all women and one fourth of all men over age fifty will have a fracture due to osteoporosis at some time during their lives. Approximately 19 billion dollars per year is spent in the United States to repair two million fractures (broken bones). Of these, 297,000 are hip fractures, 547,000 vertebral fractures, 397,000 wrists, 135,000 pelvic and 675,000 are fractures at other sites.

This “silent crippler” known as osteoporosis is generally asymptomatic until the time of a devastating fracture. A hip fracture ends up in death for about one in four people during the year following the fracture, and only 15% can walk across a room unaided six months after a fracture. In fact, a woman has a greater chance of dying following a hip fracture than from cancer of the ovary, breast, or uterus.

Osteoporosis reflects an absolute decrease in the amount of bone, which leads to a fracture after only minimal trauma. Bone loss begins starting at approximately age 30. Prior to that time bone is constantly being added to the skeleton. From mid-life onward a protracted, slow loss of bone occurs, more commonly in females than males, and is also more apparent in females who have, in general, have a smaller skeletal mass.

What can be done about osteoporosis? The answer is simple and involves taking in enough calcium to make sure that one’s bones are strong and healthy throughout one’s life. Unfortunately, many children and young adults do not realize how important taking in an adequate amount of calcium is when they are young. Fortunately, however, many older people do realize this fact and start taking calcium as they age. Obviously, the sooner one begins to take in the appropriate amount of calcium, the better one’s chances of avoiding problems with osteoporosis.

Bone is a living tissue which constantly rejuvenates itself. Cells called osteoblasts lay down new calcium, and cells called osteoclasts remove bone. Medicines in a few different families, such as bisphosphonates, estrogens, or parathyroid hormone, can decrease the activity of the osteoclasts or stimulate osteoblasts and thus increase bone density.

This balance of building and remodeling, coupled with an appropriate amount of calcium and exercise, helps prevent osteoporosis. Daily activities such as walking and swimming can also be helpful in preventing bone loss and potential broken bones from osteoporosis.

Normally, a loss of height of approximately half an inch per decade occurs after age 50. This acceleration later in life seems to be hormonally related; women who go through menopause early seem to have slightly more problems with osteoporosis.

Risk factors for osteoporosis include an inactive life style, alcohol consumption, smoking, a family history of osteoporosis, small frame and descent from certain northern European ethnicities. As one can see, a number of these risk factors are controllable. By avoiding smoking and alcohol in excess, and becoming physically active, one can decrease the chances of having osteoporosis.

Diet is very important. Taking an appropriate amount of calcium throughout one’s life is essential. Most authorities agree that between 1,000 and 1,500 milligrams of calcium per day is desirable. Dairy products are excellent sources of calcium. If one were to drink a quart of milk a day or eat the equivalent amount of calcium from an early age onward, many of these late life problems could be entirely avoided.

The more one knows about any illness or condition, the better one is able to care of oneself. Osteoporosis is a perfect example of an illness which can be largely prevented by education. This Mother’s Day, let’s help all the women in our lives, particularly the moms who deserve some special recognition.

Past Health Advice Articles

Dr. Allen Weiss is CEO & President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.