Osteoporosis: Common, Serious, Preventable

Osteoporosis caused more hospitalizations than heart attacks, strokes and breast cancer combined among persons on Medicare in 2015. Nearly 2 million people suffered 2.3 million fractures in 2015 despite the existence of effective preventive measures. Over 40% of persons having a fracture require hospitalization and 20% to 30% died within one year of having a hip fracture. The most common fractures are those occurring in the hip and the spine.

Osteoporosis is a medical condition in which the density (the thickness and strength) of the bones is decreased making them brittle and more likely to break. It is estimated that 1 in 3 women and 1 in 5 men will experience an osteoporosis-related fracture in their lifetimes. Osteoporosis typically has no symptoms in the early stages and therefore it is important to screen for this condition in at risk populations before a fracture occurs. Risk factors include age over 50 years, females after menopause, smoking, lack of exercise, Vitamin D deficiency and a diet that is low in calcium.

The National Osteoporosis (NOF) recommends screening for osteoporosis using a DEXA scan. DEXA is a radiology study that uses only tiny amounts of x-rays in order to measure the bone density. DXA scans are covered by Medicare and commercial insurance. The NOF recommend screening for: Women in menopause who have additional risk factors; All women age 65 years and older; Men over the age of 50 with risk factors; All men age 70 years and older. If you have broken a broken bone that was not related to trauma or you have lost more than 1½ inches in your height, you show also have this study. If you smoke, stop! Avoid excess alcohol and caffeine intake.

Prevention of osteoporosis includes having an adequate amount of calcium in your diet. Women should eat 1200 mg of calcium each day and men 1000 mg each day. Vitamin D intake should be 800-1000 IU each day, using supplements if needed. Regular weight-bearing and muscle-strengthening exercise improve both bone strength and balance. Good balance help to avoid falls that can result in bone fractures.

There are an expanding number of medicines that may be prescribed for the prevention and treatment of osteoporosis. Bisphosphonates (alendronate, risedronate, zoledronic acid) work by protecting the bone against thinning and also lead to improvement in the bone mineral density. The oral forms of the medicine may be taken on a weekly basis. While zoledronic acid is given as a yearly infusion. These are medicines that are most commonly prescribed.

Denosumab is an antibody (a protein made by your immune system) that is also a highly effective treatment. It is given by a subcutaneous inject once every 6 months. It is important to have normal calcium and vitamin D levels prior to taking these medicines.

Other medicines that may be used on a short-term basis if necessary. Your provider will assist you in making the right choice of treatment. They also know how to watch for side effects of the medications.