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1232
22nd Street N.W.
Washington, D.C.
20037-1202
(202) 223.2226
1 (800) 231.4222 |
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Fast Facts |
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Definition |
Osteoporosis, or
porous bone, is a disease characterized by low
bone mass and
structural deterioration of bone tissue, leading
to bone fragility and an increased
susceptibility to fractures, especially of the
hip, spine and wrist, although any bone
can be affected.
In simpler terms, osteoporosis is a condition in
which the bones become weak and
can break from a minor fall or, in serious
cases, from a simple action such as a
sneeze. |
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Prevention |
About 85-90% of adult
bone mass is acquired by age 18 in girls and
20 in boys.
Building strong bones during childhood and
adolescence can help to prevent
osteoporosis later in life.
There are five steps, which together can
optimize bone health and help prevent osteoporosis. They are:
1. Get the daily recommended amounts of
calcium and vitamin D
2. Engage in regular weight-bearing and
muscle-strengthening exercise
3. Avoid smoking and excessive alcohol
4. Talk to your healthcare provider about
bone health
5. Have a bone density test and take
medication when appropriate
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Prevalence |
Osteoporosis is a major public health threat for
an estimated 44 million
Americans, or 55 percent of the people 50 years
of age and older.
In the U.S. today, 10 million individuals are
estimated to already have the
disease and almost 34 million more are estimated
to have low bone mass,
placing them at increased risk for osteoporosis.
While osteoporosis is often thought of as an
older person's disease, it can strike
at any age.
Osteoporosis Prevalence: Gender
Of the 10 million Americans
estimated to have osteoporosis, eight million
are women
and two million are men.
Eighty percent of those affected
by osteoporosis are women.
Twenty percent of those affected
by osteoporosis are men.
Osteoporosis Prevalence: Race/Ethnicity
Significant risk has been
reported in people of all ethnic backgrounds.
Twenty percent of non-Hispanic
Caucasian and Asian women aged 50 and older are
estimated to have osteoporosis, and 52 percent
are estimated to have low bone mass.
Seven percent of non-Hispanic
Caucasian and Asian men aged 50 and older are
estimated to have osteoporosis, and 35 percent
are estimated to have low bone mass.
Five percent of non-Hispanic
black women over age 50 are estimated to have
osteoporosis; an estimated additional 35 percent
have low bone mass that puts them at risk of
developing osteoporosis.
Four percent of non-Hispanic
black men aged 50 and older are estimated to
have osteoporosis, and 19 percent are estimated
to have low bone mass.
Osteoporosis is under recognized
and under-treated not only in Caucasian women,
but in African-American women as well.
Ten percent of Hispanic women
aged 50 and older are estimated to have
osteoporosis, and 49 percent are estimated to
have low bone mass.
Three percent of Hispanic men
aged 50 and older are estimated to have
osteoporosis, and 23 percent are estimated to
have low bone mass.
When compared with other
ethnic/racial groups, risk is increasing most
rapidly among Hispanic women.
Experts predict that costs
related to osteoporotic fractures among
Hispanics will increase from an estimated $754
million in 2005 to $2 billion per year in 2025. |
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Cost |
In 2005, osteoporosis-related fractures were
responsible for an estimated $19 billion
in costs.
By 2025, experts predict that these
costs will rise to approximately $25.3 billion. |
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Symptoms |
People cannot feel their bones getting
weaker. They may not know that they have
osteoporosis until they break a bone. A person
with osteoporosis can break a bone from a minor
fall, or in serious cases, from a simple action
such as a sneeze.
Vertebral (spinal) fractures may initially be
felt or seen in the form of severe back pain,
loss of height, or spinal deformities such as
kyphosis or stooped posture. In many cases, a
vertebral fracture can even occur with no pain. |
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Risk Factors |
Certain people are more
likely to develop osteoporosis than others.
Factors that
increase the likelihood of developing
osteoporosis and broken bones are called
"risk
factors." Many of these risk factors
include:
- Being female
- Older age
- Family history of osteoporosis or broken
bones
- Being small and thin
- Certain race/ethnicities such as
Caucasian, Asian, or Hispanic/Latino
although
African Americans are also at risk
- History of broken bones
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Low sex hormones
Diet
Inactive lifestyle
Smoking
Alcohol abuse
Certain medications such as steroid
medications, some anticonvulsants and
others
Certain diseases and conditions such as
anorexia nervosa, asthma and others
Loss of height (which may indicate a
spinal fracture)
Women can lose up to 20 percent of their
bone mass in the five to seven years after
menopause, making them more susceptible to
osteoporosis. |
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Fractures |
One in two women and one in
four men over age 50 will have an
osteoporosis-related
fracture in their remaining lifetime. Fractures due to osteoporosis are most likely
in the hip, spine and wrist, but any bone
can be affected.
According to estimated figures, osteoporosis
was responsible for more than 2 million
fractures in 2005, including approximately:
- 297,000 hip fractures
- 547,000 vertebral fractures
- 397,000 wrist fractures
- 135,000 pelvic fractures
- 675,000 fractures at other sites
The total number of fractures due to
osteoporosis is expected to rise to more than 3
million by 2025.
Women with a hip fracture are at a four-fold
greater risk of a second one.
Fractures due to osteoporosis lower a
patient’s quality of life.
The rate of hip fractures is two to three
times higher in women than men; however,
the one year mortality following a hip fracture
is nearly twice as high for men as for
women.
A woman's risk of hip fracture is equal to her
combined risk of breast, uterine and
ovarian cancer.
In 2005, about 293,000 Americans age 45 and
over were admitted to hospitals with a
fracture of the femoral neck, a common type of
hip fracture. Osteoporosis was the
underlying cause of most of these injuries.
An average of 24 percent of hip fracture
patients aged 50 and over die in the year
following their fracture.
One in five of those who were ambulatory
before their hip fracture requires long-term
care afterward.
At six months after a hip fracture, only 15
percent of hip fracture patients can walk
across a room unaided.
In addition to hip fractures, vertebral
fractures are also linked to an increased risk
of
death.
Caucasian women aged 65 or older have twice
the incidence of fractures as African-
American women.
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Diagnosis |
Specialized tests called bone mineral
density (BMD) tests can measure bone density
in various sites of the body. Experts recommend
a type of BMD test using a central
DXA (which stands for dual energy x-ray absorptiometry).
A BMD test performed by a central DXA can:
- Tell if a person has low bone density before a
fracture occurs
- Tell if a person’s bones are losing bone
density or staying the same when the
test is repeated at intervals of one year or
more
- Predict the chances that a person will have a
fracture in the future
- Help a person and their healthcare provider
decide if treatment is needed
A new methodology called absolute fracture
risk takes into account a person’s BMD
and other risk factors to estimate the
likelihood of breaking a bone due to low bone
mass or osteoporosis over a period of 10 years.
This new tool helps healthcare
providers and patients make better treatment
decisions and assure that people with
the highest fracture risk get treated.
Medicare reimburses for BMD testing every two
years.
An increase in BMD testing and osteoporosis
treatment was associated with a
decrease in hip fracture incidence.
BMD is an important determinant of fracture
risk even in nursing home patients.
There has been a five-fold increase in office
visits for osteoporosis (from 1.3 to 6.3
million) in the past 10 years. |
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Medications |
Although there is no cure
for osteoporosis, it can be treated. The
following medications are
approved by the FDA to prevent and/or treat
osteoporosis:
Antiresorptive Medications – Bisphosphonates
- Alendronate and alendronate plus vitamin D3
(brand names Fosamax® and
Fosamax plus D™).Alendronate is approved for the
prevention and treatment of
osteoporosis in post-menopausal women and for
the treatment of osteoporosis in
men. It also is approved for the treatment of
glucocorticoid-induced osteoporosis in
men and women as a result of long-term use of
steroid medications.
- Ibandronate (brand name Boniva®). Ibandronate
is approved for the prevention
and treatment of osteoporosis in postmenopausal
women.
- Risedronate and risedronate with calcium
(brand names Actonel® and
Actonel® with Calcium). Risedronate is approved
for the prevention and treatment
of osteoporosis in postmenopausal women and for
the treatment of osteoporosis in
men. It also is approved for the prevention and
treatment of glucocorticoid-induced
osteoporosis in men and women as a result of
long-term use of steroid medications.
- Zoledronic Acid (brand name Reclast®). Zoledronic acid is approved for the
treatment of osteoporosis in postmenopausal
women.
Other Antiresorptive Medications
- Calcitonin (brand names Fortical® and
Miacalcin®). Calcitonin is approved for the
treatment of osteoporosis in postmenopausal
women who are at least five years
beyond menopause.
- Estrogen (multiple brand names available)
Estrogen therapy (ET) and estrogen with progesterone hormone therapy (HT) are
approved for the prevention of
osteoporosis in postmenopausal women. According
to the FDA, postmenopausal
women should consider other medications before
taking ET or HT to prevent
osteoporosis due to risks associated with these
medications. They should also be
used in the lowest possible dose for the
shortest period of time to meet treatment
goals.
- Estrogen Agonists/Antagonists also known as
Selective Estrogen Receptor
Modulators (SERMs) –Raloxifene (brand name
Evista®). Raloxifene is approved
for the prevention and treatment of osteoporosis
in postmenopausal women.
Bone Forming (Anabolic) Medications
- Parathyroid Hormone –Teriparatide (brand name
- Forteo®). Teriparatide, a type
of parathyroid hormone, is approved for the
treatment of osteoporosis in
postmenopausal women and in men who have very
low BMD or are at high risk for a
fracture. Teriparatide can only be taken for two
years.
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Medical experts agree that
osteoporosis is highly preventable. However, if
the toll of osteoporosis is to be reduced, the
commitment to osteoporosis research must be
significantly increased. It is reasonable to
project that with increased research, the future
for definitive treatment and prevention of
osteoporosis is very bright.
The National Osteoporosis
Foundation (NOF) is the nation's leading
resource for patients, healthcare professionals
and organizations seeking up-to-date, medically
sound information on the causes, prevention,
diagnosis and treatment of osteoporosis. Please
contact us to learn more about
NOF or how to become a member. |
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