OsteoporosisOsteoporosis

Bone BasicsBone Basics

Bones are complex, living tissues that:Bones are complex, living tissues that: Provide structural support for muscles, Provide structural support for muscles, Protect vital organsProtect vital organs Store the calcium essential for bone density Store the calcium essential for bone density

and strengthand strength Bones are built and stored until the age Bones are built and stored until the age

of 30.of 30. During the aging process, bones break During the aging process, bones break

down faster than new ones are formed.down faster than new ones are formed.

Osteoporosis: What is it?Osteoporosis: What is it?

Disease in which bones become Disease in which bones become fragile and more likely to break.fragile and more likely to break.

Broken bones, or fractures, Broken bones, or fractures, typically occur in hip, spine, and typically occur in hip, spine, and wrist.wrist.

Osteoporosis FactsOsteoporosis Facts 10 million Americans have osteoporosis; 10 million Americans have osteoporosis;

34 million at risk.34 million at risk.11

8 million are women; 2 million are men. 8 million are women; 2 million are men. 11

Significant risk for all ethnic Significant risk for all ethnic backgrounds. backgrounds. 11

Can strike at any age. Can strike at any age. 11

Responsible for more than 1.5 million Responsible for more than 1.5 million fractures annually. fractures annually. 11

1. “Osteoporosis Fast Facts.” National Osteoporosis Foundation. February 17, 2005. http://www.nof.org.1. “Osteoporosis Fast Facts.” National Osteoporosis Foundation. February 17, 2005. http://www.nof.org.

SymptomsSymptoms ““Silent disease”Silent disease” Collapsed vertebrae may be initially Collapsed vertebrae may be initially

seen or felt in the form of:seen or felt in the form of: Severe back painSevere back pain Loss of heightLoss of height Spinal deformities such as kyphosis or Spinal deformities such as kyphosis or

stooped posturestooped posture

Risk FactorsRisk Factors Personal history of fracture after age 50Personal history of fracture after age 50 Current low bone massCurrent low bone mass FemaleFemale Thin and/or having a small frame (under 127 Thin and/or having a small frame (under 127

lbs.)lbs.) Advanced ageAdvanced age Estrogen deficiency as a result of menopause, Estrogen deficiency as a result of menopause,

especially early or surgically inducedespecially early or surgically induced Abnormal absence of menstrual periodsAbnormal absence of menstrual periods Anorexia nervosaAnorexia nervosa

Risk Factors (cont.)Risk Factors (cont.)

Low lifetime calcium intakeLow lifetime calcium intake Vitamin D deficiencyVitamin D deficiency Use of certain medicationsUse of certain medications Presence of certain chronic medical Presence of certain chronic medical

conditionsconditions Low testosterone levels in menLow testosterone levels in men Inactive lifestyleInactive lifestyle Current cigarette smokingCurrent cigarette smoking Excessive use of alcoholExcessive use of alcohol

DetectionDetection

Bone density tests can:Bone density tests can: Detect osteoporosis before a fracture occursDetect osteoporosis before a fracture occurs Predict future chances of fracturesPredict future chances of fractures Determine your rate of bone loss and/or Determine your rate of bone loss and/or

monitor the effects of treatmentmonitor the effects of treatment Bone density is compared to two Bone density is compared to two

standards:standards: Age matchedAge matched Young normalYoung normal

PreventionPrevention

Steps to optimize bone health and Steps to optimize bone health and prevent osteoporosis:prevent osteoporosis: Keep a balanced diet rich in calcium Keep a balanced diet rich in calcium

and vitamin Dand vitamin D Exercise regularly (weight-bearing)Exercise regularly (weight-bearing) Maintain a healthy lifestyle (no Maintain a healthy lifestyle (no

smoking or excessive alcohol intake)smoking or excessive alcohol intake) Bone density testing and medication Bone density testing and medication

when appropriatewhen appropriate

Recommended Calcium IntakesRecommended Calcium Intakes11

AgesAges Amount mg/dayAmount mg/day

Birth- 6 monthsBirth- 6 months 210210

6 months- 1 year6 months- 1 year 270270

1-31-3 500500

4-84-8 800800

9-139-13 13001300

14-1814-18 13001300

19-3019-30 10001000

31-5031-50 10001000

51-7051-70 12001200

70 or older70 or older 12001200

Pregnant & LactatingPregnant & Lactating 10001000

14-1814-18 13001300

19-5019-50 10001000

1. Source: National Academy of Sciences (NAS).

Ways to Increase Calcium Ways to Increase Calcium IntakeIntake

Diet of calcium-rich food:Diet of calcium-rich food: Low-fat milkLow-fat milk CheeseCheese BroccoliBroccoli YogurtYogurt Calcium-added foods (breakfast bars, orange juice, Calcium-added foods (breakfast bars, orange juice,

cereals)cereals) Add nonfat powdered dry milk to puddings, Add nonfat powdered dry milk to puddings,

breads, soups, etc.breads, soups, etc. SupplementsSupplements

Available in pills, capsules, chewable tablets, Available in pills, capsules, chewable tablets, chewable candies, powders and tablets.chewable candies, powders and tablets.

Suggestions for Choosing Suggestions for Choosing SupplementsSupplements

Determine your daily calcium Determine your daily calcium intake from food.intake from food.

Decide which form of calcium will Decide which form of calcium will be the easiest for you to take.be the easiest for you to take.

Calcium absorbs better in small Calcium absorbs better in small doses and with food.doses and with food.

Vitamin D is essential for calcium Vitamin D is essential for calcium absorption.absorption.

MedicationsMedications

No cure for osteoporosisNo cure for osteoporosis Following medications approved to Following medications approved to

prevent/or treat osteoporosis:prevent/or treat osteoporosis: BisphosphonatesBisphosphonates CalcitoninCalcitonin Estrogen/Hormone TherapyEstrogen/Hormone Therapy Parathyroid HormoneParathyroid Hormone Selective Estrogen Receptor Selective Estrogen Receptor

ModulatorsModulators

Fall PreventionFall Prevention

Especially important for osteoporosis Especially important for osteoporosis sufferers.sufferers.

Falls can be caused by:Falls can be caused by: Medications such as sedatives, muscles Medications such as sedatives, muscles

relaxants and blood pressure drugs.relaxants and blood pressure drugs. Combinations of two or more drugs.Combinations of two or more drugs. Diminished vision, hearing, muscle Diminished vision, hearing, muscle

strength, coordination and reflexes.strength, coordination and reflexes.

Safety ChecklistSafety Checklist Floors: Floors:

Remove all loose wires, cords, and throw Remove all loose wires, cords, and throw rugs. rugs.

Keep furniture in its accustomed place.Keep furniture in its accustomed place. Bathrooms: Bathrooms:

Install grab bars and non-skid tape.Install grab bars and non-skid tape. Lighting: Lighting:

Make sure halls, stairways and entrances Make sure halls, stairways and entrances are well-lit. are well-lit.

Install night lightsInstall night lights

Safety Checklist cont.Safety Checklist cont. Kitchen: Kitchen:

Install non-skid mats near sink and stove. Install non-skid mats near sink and stove. Clean spills immediately.Clean spills immediately.

Stairs: Stairs: Make sure treads, rails and rugs are secure.Make sure treads, rails and rugs are secure.

Other precautions: Other precautions: Wear sturdy, rubber-soled shoes. Wear sturdy, rubber-soled shoes. Limit alcohol intake. Limit alcohol intake. Ask doctor if medications might cause falls.Ask doctor if medications might cause falls.

Questions?Questions?

Thank You!Thank You!