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Fast Facts on Osteoporosis
Definition Definition Osteoporosis is a disease in which the bones become weak and are more likely to break. People with osteoporosis most often break bones in the hip, spine, and wrist.
In the United States, 10 million people have osteoporosis. Millions more have low bone mass (called osteopenia), placing them at risk for osteoporosis and broken bones. Osteoporosis can strike at any age, but it is most common in older women. Eighty percent of the people in the United States with osteoporosis are women. One out of every two women and one in four men over age 50 will break a bone in their lifetime due to osteoporosis.
The cost of osteoporosis to society is high. In 2002 dollars, between $12.2 billion and $17.9 billion was spent in the United States on hospitals and nursing homes for people with osteoporosis-related and associated fractures, and the costs are rising. The indirect costs of the disease, such as those resulting from reduced productivity and lost wages, are unknown. In addition to the financial costs, osteoporosis takes a toll in terms of reduced quality of life for many people who suffer fractures. It can also affect the lives of family members and friends who serve as caregivers.
Osteoporosis is called the "silent disease" because bone is lost with no signs. You may not know that you have osteoporosis until a strain, bump, or fall causes a bone to break.
Factors that are linked to the development of osteoporosis or contribute to an individual's likelihood of developing the disease are called risk factors. Many people with osteoporosis have several risk factors for the disease, but others who develop osteoporosis have no identified risk factors. There are some risk factors that you cannot change, and others that you can or may be able to change. Risk factors you cannot change: Sex: Your chances of developing osteoporosis are greater if you are a woman. Women have lower peak bone mass and smaller bones than men. They also lose bone more rapidly than men in middle age because of the dramatic reduction in estrogen levels that occurs with menopause. Age: The older you are, the greater your risk of osteoporosis. Bone loss builds up over time, and your bones become weaker as you age. Body size: Slender, thin-boned women are at greater risk, as are, surprisingly, taller women. Race: Caucasian (white) and Asian women are at highest risk. African American and Hispanic women have a lower but significant risk. Among men, Caucasians are at higher risk than others. These differences in risk can be explained in part - although not entirely - by differences in peak bone mass among these groups. Family history: Susceptibility to osteoporosis and fractures appears to be, in part, hereditary. People whose parents have a history of fractures also tend to have reduced bone mass and an increased risk for fractures. Risk factors you can or may be able to change:
Sex hormone deficiencies: The most common manifestation of estrogen deficiency in premenopausal women is amenorrhea, the abnormal absence of menstrual periods. Missed or irregular periods can be caused by various factors, including hormonal disorders as well as extreme levels of physical activity combined with restricted calorie intake - for example, in female marathon runners, ballet dancers, and women who spend a great deal of time and energy working out at the gym. Low estrogen levels in women after menopause and low testosterone levels in men also increase the risk of osteoporosis. Lower than normal estrogen levels in men may also play a role. Low testosterone and estrogen levels are often a cause of osteoporosis in men being treated with certain medications for prostate cancer. Diet: From childhood into old age, a diet low in calcium and vitamin D can increase your risk of osteoporosis and fractures. Excessive dieting or inadequate caloric intake can also be bad for bone health. People who are very thin and do not have much body fat to cushion falls have an increased risk of fracture. Certain medical conditions: In addition to sex hormone problems and eating disorders, other medical conditions - including a variety of genetic, endocrine, gastrointestinal, blood, and rheumatic disorders - are associated with an increased risk for osteoporosis. Anorexia nervosa, for example, is an eating disorder that leads to abnormally low body weight, malnutrition, amenorrhea, and other effects on the body that adversely affect bone health. Late onset of puberty and early menopause reduce lifetime estrogen exposure in women and also increase the risk of osteoporosis. Medications: Long-term use of certain medications, including glucocorticoids and some anticonvulsants, leads to bone loss and increased risk of osteoporosis. Other drugs that may lead to bone loss include anticlotting drugs, such as heparin; drugs that suppress the immune system, such as cyclosporine; and drugs used to treat prostate cancer. An inactive lifestyle or extended bed rest: Low levels of physical activity and prolonged periods of inactivity can contribute to an increased rate of bone loss. They also leave you in poor physical condition, which can increase your risk of falling and breaking a bone. Excessive use of alcohol: Chronic heavy drinking is a significant risk factor for osteoporosis. Smoking: Most studies indicate that smoking is a risk factor for osteoporosis and fracture, although the exact reasons for the harmful effects of tobacco use on bone health are still unclear.
A bone mineral density test (called a DXA) is the best way to check your bone health. This test can:
There are many steps you can take to keep your bones healthy. To keep your bones strong and slow down bone loss, you can:
Nutrition A diet with enough calcium and vitamin D helps make your bones strong. Many people get less than half the calcium they need. Good sources of calcium are:
Vitamin D is needed for strong bones. Your body makes vitamin D in the skin when you are out in the sun. Some people get all the vitamin D they need from sunlight. Others need to take vitamin D pills. The chart on this page shows the amount of calcium and vitamin D you should get each day.
Exercise Exercise helps your bones grow stronger. To increase bone strength, you can:
Smoking is bad for bones as well as the heart and lungs. Also, people who drink a lot of alcohol are more prone to bone loss and broken bones due to poor diet and risk of falling.
Although low bone mass (or low bone density) plays an important role in determining a person's risk of osteoporosis, it is only one of many risk factors for fractures. Fracture risk results from a combination of bone-dependent and bone-independent factors. Various aspects of "bone geometry," such as tallness, hip structure, and thighbone (femur) length, can also affect your chances of breaking a bone if you fall. Increasing age, excessive weight loss, a history of fractures since age 45, having an existing spine fracture, and having a mother who fractured her hip all increase the risk of hip fracture independent of a person's bone density, and individuals with more risk factors have a higher chance of suffering a hip fracture. Factors that increase the likelihood of falling and the severity of falls also contribute to fracture risk. These include decreased muscle strength, poor balance, impaired eyesight, and impaired mental abilities. The angle at which you fall also affects your risk of fracture. Use of certain medications, such as tranquilizers and muscle relaxants, and hazardous elements in your living environment, such as slippery throw rugs and icy sidewalks, can also increase your risk of falls. Information on falls and fall prevention is provided in "Treating Osteoporosis." Risk Factors for Fractures
Medications Associated With Osteoporosis
For more information, see:
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