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Osteoporosis: Treating and Preventing the Most Common Bone Disorder in Women and Men
Dr. Pignolo is Assistant Professor and Director, Ralston-Penn Clinic for Osteoporosis & Related Bone Disorders, Department of Medicine, Division of Geriatric Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA.
Osteoporosis is one of the most common disorders in the U.S. While women are particularly susceptible to developing osteoporosis, men should not consider themselves immune to it. One in two women and one in four men above the age of 50 will have an osteoporosis-related fracture in their lifetime.(1) In the U.S., a woman’s risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancers.(2)
While osteoporosis is in theory simply a disorder of the bones, it can have many other effects: People with bone fractures due to osteoporosis often experience pain, dependence, and depression.(3) Only about 40% of those who have hip fractures are able to return to their previous levels of activity in their daily lives.
The vast majority of fractures that require hospitalization for people over 60 are due to osteoporosis(6)(7) and there is, unfortunately, an increased mortality rate for people with hip fractures from osteoporosis.(4)(5)
Luckily, our understanding of osteoporosis has expanded greatly in recent years, and there are many effective options for both the treatment and prevention of osteoporosis. So why does the problem persist? One reason is that many people are unaware of the steps they can take to prevent osteoporosis, and sadly, a great many people are only diagnosed with either advanced osteoporosis or after they actually have had a fracture, when the opportunity for primary prevention has passed, and it is too late for treatments to make a big difference.(10)(12)(13)(14)(15)(16)
Patients and sometimes, their doctors, are not as aware as they should be of current osteoporosis prevention and treatment guidelines. In some areas clinicians do not have access to the best diagnostic tests, like bone mineral density (BMD) tests, and this can also negatively affect a patient's outcome.
This article outlines the factors that contribute to osteoporosis, how osteoporosis is diagnosed, how to go about treating it once you are diagnosed, and preventing it if you are at risk (which many of us are). Since there is a lot we can do to reduce our risk of fractures occurring in the future, we will also discuss the lifestyle changes and medications that can help reduce risk of developing the disorder down the road.