AGING
June 17, 2008

Osteoporosis Guidelines Revised to Be More Inclusive

According to new guidelines set by the National Osteoporosis Foundation, post−menopausal women over 50 aren't the only people doctors need to monitor for the prevention and treatment of osteoporosis. Men over 50 and post−menopausal African−American, Asian, and Latina women also need to have their bone density watched.

The new guidelines make use of a computer program developed by World Health Organization (WHO). By analyzing a person's bone mass density and nine personal factors such as weight, race, history of fractures, and gender, the program can estimate the individual's 10−year fracture risk due to low bone mass. This will "help identify high−risk subgroups of men and non−Caucasian women and, we hope, a wider population of patients at risk for osteoporosis will be treated," said Bess Dawson−Hughes, M.D., director of the Bone Metabolism Laboratory at Tufts University and chair the committee responsible for the new guidelines.

Men over 50 and post−menopausal African−American, Asian, and Latina women also need to have their bone density watched.

An economic analysis done by Dawson−Hughes and her colleagues found that treating people with low bone mass who have a 3 percent or greater 10−year risk of hip fracture or a 20 percent or greater risk of other major fracture is more cost−effective than waiting for a fracture to occur. In addition, preventing fractures in older people significantly improves their quality of life.

It is hoped that the new guidelines will expand awareness, prevention, and treatment of osteoporosis in previously under−recognized groups. The new guidelines also recommend:

  • Bone mass testing for all women age 65 and older, men age 70 and older, and post−menopausal women between the ages of 50 and 70 with certain risk factors
  • Treatment of people with low bone mass in the bones of the hip joint or spine.
  • Performing regular weight−bearing exercise to strengthen muscles and reduce the risk of falls
  • A daily intake of at least 1200 mg of calcium and 800 to 1000 IU of vitamin D through diet and supplements to strengthen bones, even when signs of osteoporosis are not present.

"Post menopausal women remain the most vulnerable to osteoporetic fractures," said Dawson−Hughes, "yet clinicians should not overlook men because their fracture risk may be lower."

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