Osteoporosis is low bone density associated with increased risk of fracture.  There are no symptoms.  It is most often discovered often after a fracture, especially a low trauma fracture.

Osteoporosis is most often associated with women, but men can also be at risk.

What are risk factors of osteoporosis?

Postmenopausal women:  bone density decreases at a more rapid rate

Advanced age:  80’s and 90’s

Low trauma fracture: break a bone without a trauma

Long term glucocorticoid therapy: steroids

Low body weight:  less than 127 lbs, especially if body weight has always been low

Family history of hip fracture

Smoking cigarettes

Excessive alcohol intake

Caucasians are at higher risk

What is peak bone mass?

Peak bone mass is the maximum amount of bone developed (bone mass) in a person's life, typically around age 30.  The stronger the bones at age 30, the less risk of osteoporosis.

What screening tests are there for osteoporosis?

Dexa Scan:  x ray that evaluates the density of the bone usually at the hips and lumbar/low spine.  This also includes a statistical analysis that compares the results with what is considered normal.  Given a score called a T Score that will estimate your risk of fracture in the next ten years.

Women over 65 can get a Dexa Scan.  Anyone with risk factors can also get a screening Dexa Scan.

FRAX: (risk assessment calculator)  questionnaire that takes into account a person’s risk factors and gives an estimated fracture risk for the next ten years.

Anyone who shows high risk for fracture should talk to their doctor about treatment.

Talk to your doctor about your specific situation, especially if you feel you are at risk earlier.

Treatment Options:

Medication:  discuss with your doctor to find out what is best for you

The best option is PREVENTION and lowering your risk factor early.

If you or someone in your family is under 30 years old, start now to help increase bone density prior to the age of peak bone mass.  If you or your family member is over 30, take the same measures to help reduce risk factors.

Preventing fractures affects the whole family.  Fractures in elderly are life altering.

Know risk, get screened

Get treatment

Make sure younger children are getting enough calcium intake.  Teenagers, particularly females, should take added calcium.

Take precautions to prevent and reduce risks of falls

Handrails in bathrooms, on all steps

No loose rugs

Wrap up invitation

If you’re over 65 and haven’t had an osteoporosis screening yet, do so.

Talk to your doctor about personal risk factors, especially if you have a parent who had a hip fracture.

No matter what age you are, take preventative measures by getting adequate calcium, living a healthy lifestyle, not smoking, and no excessive alcohol intake.

Ensure young kids and teens get adequate calcium.

Get rid of loose rugs and add plenty of handrails as needed for elderly family members.

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A Health Screening is a test that looks for a problem or disease when no symptoms are present.  We recommend everyone have a yearly wellness visit with your personal physician and ask them about any screenings you may need. 

Pap Smear:  looking for cervical cancer cells or dysplasia (abnormal, possible precancerous cells).  Begin at 21.  If normal, repeat every 3-5 years. 

Human Papilloma Virus (HPV): responsible for most cervical cancers.  Screening starts at age 30 and continues every 5 years.

Breast Cancer Screening - Mammogram: Begin screenings between age 40-50 and continue every 1-2 years.  Talk to your doctor about family history of breast cancer or other risk factors.

Chlamydia Screening:  Sexually active women younger than 25.  Men and women at any age with multiple sex partners.  Screening is done with a urine sample.

Prostate Cancer Screening:  Some recommend PSA (prostate-specific antigen), but some do not.  We will have a full episode on men’s health to discuss this. Men should talk to their doctor about recommendations.

Colon Cancer Screening:  Options include colonoscopy, fecal occult blood test and barium enema with flexible sigmoidoscopy. Most common and accurate is the colonoscopy which is recommended at age 50 unless at higher risk. You are at higher risk if you have a relative who had colon cancer and should discuss that with your doctor.  During a colonoscopy polyps can be removed. Clear colonoscopies can be done every 10 years.

Lung Cancer Screening:  Low radiation dose CT scan for people older than 65 who smoke or quit smoking less than 15 years ago and who have a 30 pack year history (1 pack a day for 30 years or 2 packs for 15 years)

Abdominal Aortic Aneurysm Screening: This screen is looking for symptoms of an aneurysm in the largest blood vessel, the aorta.  Men 65 or older who have ever smoked need an abdominal ultrasound to check the size of the aorta.  If enlargement of the vessel is found, your doctor will follow up with more tests.

Lipid screening:  Lipids are Cholesterol, Total Cholesterol, High Density Lipoproteins (HDL), Low Density Lipoproteins (LDL), and Triglycerides.  Everyone should be screened for lipid disorders in adulthood and continue screenings every 5 years if normal.  Keeping these levels in check will help reduce the risk of heart disease and stroke in the future. 

Hypertension Screening: at each doctor visit, vital signs checked, including blood pressure.  Treat if it is high.

Diabetes Screening:  Have a screening early in adulthood to get a baseline blood glucose level.  If level normal, check again every 5 years. 

If there is a family history of high cholesterol, hypertension or diabetes, testing more frequently may be appropriate.  When any of these are high it can contribute to heart disease and risk of stroke.  

Hepatitis C Screening:  All baby boomers (currently 55-75 years old) should be screened.  People at higher risk include IV drug user or someone who has had blood transfusions.  This is rare today because of improved blood screening practices. 

HIV Screening:  Everyone should be screened at some point, especially if you are at risk

Depression Screening:  It is a questionnaire that you complete at your doctor visit that helps determine risk.  You can also find and do a questionnaire on your own and talk to your doctor if you score high.  Also, if you have any concerns without a questionnaire, if you have been feeling symptoms of depression or if you have a family history, please talk to your doctor.