Osteoporosis is a loss of bone density that can occur as we age. It is responsible for over a million broken bones each year, and is a major cause of fractures, back pain, spinal problems and loss of independence. Ten million Americans are living with osteoporosis today, and the Centers for Disease Control and Prevention (CDC) estimates that by the year 2020 one in two Americans over age 50 will be at risk for fractures from osteoporosis. With the aging of the baby boomers, awareness of the disease becomes ever more important.

Yet many people, even seniors who are at high risk for osteoporosis, are unaware of the dangers of the disease and their own risk factors. Osteoporosis is sometimes called “the silent disease.” As it develops, it is often painless, with no obvious symptoms. In many cases, a fracture is the first symptom!

The American Academy of Orthopaedic Surgeons recently conducted a groundbreaking study showing that even though osteoporosis can lead to debilitating fractures, pain, spinal problems, loss of independence, and even death, many at-risk seniors have little knowledge about the disease, even if they’ve suffered an osteoporosis-related fracture. “Many people who sustain a fracture don’t connect it to osteoporosis,” said study author Dr. Angela M. Cheung of the University Health Network/Mount Sinai Hospital Osteoporosis Program in Toronto, Ontario. Cheung points out in contrast, “A person who has a heart attack knows that there’s a problem with his or her heart, but a person who fractures thinks, ‘The floor was slippery’ or ‘I’m clumsy’ and doesn’t look at it as a symptom of a more serious medical condition.”

What you should know about osteoporosis

What causes osteoporosis?

To understand what causes osteoporosis, it’s important to know that our bones are actually a living tissue. All through our lives, bone is constantly being replaced by new bone. In young people, the bones become denser and stronger. But when we are around age 35, bone building no longer keeps up with bone loss. For persons who have a strong bone mass, this gradual loss of minerals from the bones may not cause problems. But when loss of bone density is so great that bones fracture easily, the person is said to have osteoporosis.

As it develops, osteoporosis is often painless, with no obvious symptoms. In most cases, the first sign is a fracture, most often of the hip, spine or wrist. The person with osteoporosis may develop a noticeably curved spine (sometimes called a “dowager’s hump”). Another sign is a decrease of height, which is caused by loss of bone in the spine. It is important that osteoporosis be diagnosed early, so that measures can be taken to slow the bone loss. A bone mineral density test—a painless test similar to having an x-ray—is the best way to measure bone health.

What are the risk factors?

Several risk factors increase the likelihood of osteoporosis:

• aging
• a family history of the condition
• women past menopause (who have a lowered amount of estrogen, a hormone important in building bones)
• inadequate intake of calcium and Vitamin D
• an inactive lifestyle
• small-boned and/or underweight body type
• excess abdominal fat
• use of certain medications
• medical conditions such as liver or kidney disease, diabetes, or thyroid problems
• smoking or alcohol abuse.

Can osteoporosis be prevented?

For the most part, once bone has been lost, it cannot be replaced. So the goal in treating osteoporosis is to maintain existing bone and to stop further loss. Here are some things you can do:

Get enough calcium. Some good sources of calcium are dairy products, dark leafy green vegetables, dried beans, canned sardines and salmon, sesame seeds, tofu, tortillas and soy flour. Some foods that are not rich in calcium may be fortified with calcium and vitamin D; check the label on breakfast cereals, breads and orange juice. Your health care provider may also recommend calcium and Vitamin D supplements.

Maintain a healthy weight. Being underweight raises the risk of osteoporosis. On the other hand, a recent study from Harvard Medical School shows that excess abdominal fat is also detrimental to bone health. Remember that prolonged weight loss diets are dangerous: the dieter may be losing bone right along with the weight.

Get enough exercise—and the right kind. Staying active encourages bone growth and strengthens muscles to protect the bones. Seniors who have osteoporosis should consult their healthcare provider before beginning an exercise program. Certain types of exercises are most beneficial; others may actually be dangerous. A physical therapist can train the patient to use good “body mechanics” during daily activities—even during sleep.

Limit alcohol and quit smoking. Alcohol and tobacco can both contribute to weakened bone in a variety of ways. Drinking too much alcohol also increases the risk of falling and fracturing a bone.

Take medications correctly. Some osteoporosis patients take medication to slow the loss of bone. Other drugs help control pain, or manage healthcare conditions that can make osteoporosis worse. Take these medications exactly as prescribed. Some prescription and over-the-counter drugs can increase fall risk or actually weaken the bones, so have medications reviewed regularly.

Make fall prevention a priority. Reduce the risk by having regular eye examinations, keeping the house free of clutter and other hazardous conditions, and talking to your healthcare provider about a balance training program. If you use a cane, walker or other assistive device, be sure it is properly fitted and you have been trained in its use.

While some of the risk factors for osteoporosis—such as body type, family history, and age—are beyond our control, others are lifestyle choices. People who follow the above suggestions lessen the likelihood of developing osteoporosis. And though in most cases lost bone mass cannot be replaced, the same preventative measures can also slow the loss.

Seniors Helping the Next Generation

The National Osteoporosis Foundation, sponsor of National Osteoporosis Month, recently rolled out the Generations of Strength campaign to encourage parents and grandparents to talk to their children and grandchildren about the importance of building strong bones. Foundation experts say, “Many people do not realize that osteoporosis is often considered a pediatric disease with geriatrics consequences—approximately 85 – 90 percent of adult bone mass is acquired by age 18 in girls and 20 in boys.” The NOF reminds grandparents, “It’s never too early or too late to take steps to improve bone health.” Young people are least likely to think about the importance of nutrition. A conversation with Grandma might be the best way to help grandchildren develop awareness of bone health. Learn more about the campaign atwww.nof.org/connect.