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To the editor:
A new study that came out by the Journal of the
American Medical Association, finding that older men and women are
very likely to follow a bone fracture with a second, puts increased
emphasis on the need for older men to be more aware of osteoporosis
and its potential to weaken bones to the breaking point. Most
studies of bone fractures in senior citizens have focused on older
women -- the most likely to develop this disease.
"For both sexes, absolute subsequent (low-trauma) fracture risk
was equal to or greater than the risk of an initial fracture for a
woman in a 10-year-older age bracket or for a man 20 years older,"
say authors of the article in the Jan. 24 issue of the Journal of
the American Medical Association. (Abstract)
In the study of people age 60 and over, they found that 50
percent of both men and women were likely to have a second
low-trauma fracture within 10 years of their first break.
"The critical clinical relevance of these findings," the article
says, "is that incident low-trauma fracture is a signal for
increased risk of all types of subsequent osteoporotic fracture,
particularly in the next five to 10 years."
The study concludes, "Virtually all low-trauma fractures indicate
the clinical need for fracture preventive therapy, and given the
early peak of re-fracture, such preventive treatment should not be
"The lack of consideration of osteoporosis and treatment
initiatives by the medical profession and the public, particularly
in relation to men, should be the focus of education initiatives,"
the researchers conclude.
Despite substantial evidence that a prior fracture results in an
increased risk of subsequent fracture, less than 30 percent of
postmenopausal women and less than 10 percent of men with prior
fracture are treated to help lower this risk.
Although some of this deficiency in treatment is due to the
overall lack of awareness of osteoporosis by the public and primary
caregivers, the relative importance of prior fracture in relation to
subsequent fracture risk does not appear to be fully appreciated,
particularly in men, according to background information in the
article from the Journal of the American Medical Association.
There are few published long-term studies on absolute risk of
re-fracture in women, and fewer in men.
National Institute of Arthritis and Musculoskeletal and Skin
Osteoporosis is a disease in which the bones become weak and are
more likely to break. People with osteoporosis most often break
bones in the hip, spine and wrist.
Who gets osteoporosis?
In the United States, 10 million people have osteoporosis.
Millions more have low bone mass (called osteopenia), placing them
at risk for osteoporosis and broken bones.
Osteoporosis can strike at any age, but it is most common in
older women. Eighty percent of the people in the United States with
osteoporosis are women. One out of every two women and one in four
men over age 50 will break a bone in their lifetime due to
[to top of second column in this letter]
What causes osteoporosis?
Many risk factors can lead to bone loss and osteoporosis. Some of
these things you cannot change and others you can.
Risk factors you cannot change include:
Gender -- Women get
osteoporosis more often than men.
Age -- The older you
are, the greater your risk of osteoporosis.
Body size -- Small,
thin women are at greater risk.
Ethnicity -- White
and Asian women are at highest risk. Black and Hispanic women
have a lower risk.
Family history --
Osteoporosis tends to run in families. If a family member has
osteoporosis or breaks a bone, there is a greater chance that
you will too.
Other risk factors are:
Sex hormones -- Low
estrogen levels due to missing menstrual periods or to menopause
can cause osteoporosis in women. Low testosterone levels can
bring on osteoporosis in men.
Anorexia nervosa --
This eating disorder can lead to osteoporosis.
Calcium and vitamin D
intake -- A diet low in calcium and vitamin D makes you more
prone to bone loss.
Medication use --
Some medicines increase the risk of osteoporosis.
Activity level --
Lack of exercise or long-term bed rest can cause weak bones.
Smoking -- Cigarettes
are bad for bones, heart and lungs.
Drinking alcohol --
Too much alcohol can cause bone loss and broken bones.
Can osteoporosis be prevented?
There are many steps you can take to keep your bones healthy. To
keep your bones strong and slow down bone loss, you can:
A diet with enough calcium and vitamin D helps make your bones
strong. Many people get less than half the calcium they need. Good
sources of calcium are:
Low-fat milk, yogurt
Foods with added
calcium, such as orange juice, cereals and breads
Vitamin D is needed for strong bones. Your body makes vitamin D
in the skin when you are out in the sun. Some people get all the
vitamin D they need from sunlight. Others need to take vitamin D
Click here for a chart showing the amount of calcium and vitamin
D you should get each day.
Senior Issues Task Force
(Posted Feb. 15, 2007)
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