Osteoporosis can be defined as low bone mass and poor bone structure that can lead to an increased risk of fractures. Although osteoporosis can occur at any age, it is most common amongst people over 50 years of age. After the age of 30, our bones begin to gradually lose minerals at a small rate every year (under 1%). This small amount does add up over time and explains why people experience low bone density in their fifties.
Risk factors surrounding the disease fall into two basic categories, those that can be controlled and those that cannot. The following information comes from Winters-Stone,Kerri. Action Plan for Osteoporosis. USA: Human Kinetics, 2005.
Risk factors you cannot control:
-Being female
-Being thin or having a small frame
-Advanced age
-A family history of osteoporosis
-Being postmenopausal, either early or surgically induced
-Low testosterone levels in men
-Being Caucasian or Asian, although African Americans and Hispanic Americans may be at risk as well
Risk factors you can control:
-A diet low in calcium
-An inactive lifestyle
-Cigarette smoking
-Excessive use of alcohol
Risk factors you may be able to control:
-Abnormal absence of menstrual periods (amenorrhea)
-Anorexia nervosa
-Use of certain medications, such as corticosteroids and anticonvulsants
The best mode of diagnosing osteoporosis is done via DXA, or dual energy x-ray absorptiometry. In short, this shows how much mineralization exists in certain bones. This mineral density testing is an accurate gauge of actual bone strength. Stronger bones are less likely to fracture. The best way to avoid fractures is to avoid falls. Exercise that includes resistance training works both to assist in retaining bone density and improving balance. This reduces the risk of falls and subsequent fractures.
Scores associated with bone density testing are age group comparisons (Z-scores) and also (T-scores) which is a comparison made against a healthy 25 – 30 year old person of similar ethnicity, gender and race. There is more you can research to better understand actual scoring criteria and accuracy of other testing.
The National Osteoporosis Foundation recommends a bone density test for the following:
-All postmenopausal women under age 65 who have one or more additional risk factors for osteoporosis (in addition to being postmenopausal and female)
-All women age 65 and older regardless of additional risk factors
-Postmenopausal women with one or more fractures (to confirm diagnosis and determine disease severity)
-Women who are considering therapy for osteoporosis if bone density testing would facilitate the decision
-Men or women with one or more of the following: prolonged exposure to certain medications, such as steroids used to treat asthma or arthritis, anticonvulsants, and certain cancer treatments; chronic disease that affects the kidneys, lungs, stomach, and intestines and alters hormone levels; or low levels of the sex hormone testosterone
In summary, understanding your family history, risk factors and early evaluation will offer the best approach to preventing or postponing the onset of osteoporosis. As always, discuss your family medical history and any concerns you have with your physician.
