Osteoporosis Fast Facts

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1 Osteprsis Fast Facts Fast Facts n Osteprsis Definitin Osteprsis, r prus bne, is a disease characterized by lw bne mass and structural deteriratin f bne tissue, leading t bne fragility and an increased susceptibility t fractures, especially f the hip, spine and wrist, althugh any bne can be affected. In simpler terms, steprsis is a cnditin in which the bnes becme weak and can break frm a minr fall r, in serius cases, frm a simple actin such as a sneeze. Preventin Abut 85-90% f adult bne mass is acquired by age 18 in girls and 20 in bys. Building strng bnes during childhd and adlescence can help t prevent steprsis later in life. Tgether, the fllwing five steps can ptimize bne health and help prevent steprsis: Get the daily recmmended amunts f calcium and vitamin D Engage in regular weight-bearing and muscle-strengthening exercise Avid smking and excessive alchl Talk t yur healthcare prvider abut bne health Have a bne density test and take medicatin when apprpriate A study f disease management in a rural healthcare ppulatin demnstrated that a preventive prgram was able t reduce hip fractures and save mney. Prevalence Osteprsis is a majr public health threat fr an estimated 44 millin Americans, r 55 percent f the peple 50 years f age and lder. In the U.S. tday, 10 millin individuals are estimated t already have the disease and almst 34 millin mre are estimated t have lw bne mass, placing them at increased risk fr steprsis. While steprsis is ften thught f as an lder persn's disease, it can strike at any age. Osteprsis Prevalence: Gender Of the 10 millin Americans estimated t have steprsis, eight millin are wmen and tw millin are men. Eighty percent f thse affected by steprsis are wmen.

2 Twenty percent f thse affected by steprsis are men. Osteprsis Prevalence: Race/Ethnicity Cst Significant risk has been reprted in peple f all ethnic backgrunds. Twenty percent f nn-hispanic Caucasian and Asian wmen aged 50 and lder are estimated t have steprsis, and 52 percent are estimated t have lw bne mass. Seven percent f nn-hispanic Caucasian and Asian men aged 50 and lder are estimated t have steprsis, and 35 percent are estimated t have lw bne mass. Five percent f nn-hispanic black wmen ver age 50 are estimated t have steprsis; an estimated additinal 35 percent have lw bne mass that puts them at risk f develping steprsis. Fur percent f nn-hispanic black men aged 50 and lder are estimated t have steprsis, and 19 percent are estimated t have lw bne mass. Osteprsis is under recgnized and under-treated nt nly in Caucasian wmen, but in African-American wmen as well. Ten percent f Hispanic wmen aged 50 and lder are estimated t have steprsis, and 49 percent are estimated t have lw bne mass. Three percent f Hispanic men aged 50 and lder are estimated t have steprsis, and 23 percent are estimated t have lw bne mass. When cmpared with ther ethnic/racial grups, risk is increasing mst rapidly amng Hispanic wmen. Experts predict that csts related t steprtic fractures amng Hispanics will increase frm an estimated $754 millin in 2005 t $2 billin per year in In 2005, steprsis-related fractures were respnsible fr an estimated $19 billin in csts. By 2025, experts predict that these csts will rise t apprximately $25.3 billin. Symptms Peple cannt feel their bnes getting weaker. They may nt knw that they have steprsis until they break a bne. A persn with steprsis can fracture a bne frm a minr fall, r in serius cases, frm a simple actin such as a sneeze r even spntaneusly. Vertebral (spinal) fractures may initially be felt r seen in the frm f severe back pain, lss f height, r spinal defrmities such as kyphsis r stped psture. In many cases, a vertebral fracture can even ccur with n pain. Wmen can lse up t 20 percent f their bne mass in the five t seven years after menpause, making them mre susceptible t steprsis. Risk Factrs Certain peple are mre likely t develp steprsis than thers. Factrs that increase the likelihd f develping steprsis and brken bnes are called "risk factrs." Many f these risk factrs include: Being female Older age Family histry f steprsis r brken bnes Being small and thin Certain race/ethnicities such as Caucasian, Asian, r Hispanic/Latin althugh African Americans are als at risk Histry f brken bnes

3 Lw sex hrmnes Lw estrgen levels in wmen, including menpause Missing perids (amenrrhea) Lw levels f teststerne and estrgen in men Diet Lw calcium intake Lw vitamin D intake Excessive intake f prtein, sdium and caffeine Inactive lifestyle Smking Alchl abuse Certain medicatins such as sterid medicatins, sme anticnvulsants and thers Certain diseases and cnditins such as anrexia nervsa, rheumatid arthritis, gastrintestinal diseases and thers Fractures Apprximately ne in tw wmen and ne in fur men ver age 50 will have an steprsis related fracture in their remaining lifetime. Fractures due t steprsis are mst likely in the hip, spine and wrist, but any bne can be affected. Accrding t estimated figures, steprsis was respnsible fr mre than 2 millin fractures in 2005, including apprximately: 297,000 hip fractures 547,000 vertebral fractures 397,000 wrist fractures 135,000 pelvic fractures 675,000 fractures at ther sites The number f fractures due t steprsis is expected t rise t mre than 3 millin by Wmen with a hip fracture are at a fur-fld greater risk f a secnd ne. Fractures due t steprsis lwer a patient s quality f life. The rate f hip fractures is tw t three times higher in wmen than men; hwever, the ne year mrtality fllwing a hip fracture is nearly twice as high fr men as fr wmen. A wman's risk f hip fracture is equal t her cmbined risk f breast, uterine and varian cancer. In 2005, abut 293,000 Americans age 45 and ver were admitted t hspitals with a fracture f the femral neck, a cmmn type f hip fracture. Osteprsis was the underlying cause f mst f these injuries. An average f 24 percent f hip fracture patients aged 50 and ver die in the year fllwing their fracture. One in five f thse wh were ambulatry befre their hip fracture requires lng-term care afterward. At six mnths after a hip fracture, nly 15 percent f hip fracture patients can walk acrss a rm unaided. In additin t hip fractures, vertebral fractures are als linked t an increased risk f death. Caucasian wmen aged 65 r lder have twice the incidence f fractures as African- American wmen. Many peple break a bne frm steprsis after a fall. In 2005, a ttal f 15,802 persns aged >65 years died as a result f injuries frm falls.

4 Diagnsis Specialized tests called bne mineral density (BMD) tests can measure bne density in varius sites f the bdy. Experts recmmend a type f BMD test using a central DXA (which stands fr dual energy x-ray absrptimetry). A BMD test perfrmed by a central DXA can: Tell if a persn has lw bne density befre a fracture ccurs Tell if a persn s bnes arelsing bne density r staying the same when the test is repeated at intervals f ne year r mre Predict the chances that a persn will have a fracture in the future Help a persn and his r her healthcare prvider decide if treatment is needed In the near future, sme DXA machines will be able t prvide a reprt that gives infrmatin n a persn s Abslute Fracture Risk. This reprt incrprates a persn s bne mineral density results, age and sme f the imprtant risk factrs fr steprsis and fractures. The infrmatin in this reprt will be used t help determine a persn s risk f breaking a bne in the next 10 years. This predictin f abslute fracture risk will help bth healthcare prviders and patients decide whether treatment with an steprsis medicatin is needed. Medicare reimburses fr BMD testing every tw years. An increase in BMD testing and steprsis treatment was assciated with a decrease in hip fracture incidence. BMD is an imprtant determinant f fracture risk even in nursing hme patients. There has been a five-fld increase in ffice visits fr steprsis (frm 1.3 t 6.3 millin) in the past 10 years. Medicatins Althugh there is n cure fr steprsis, it can be treated. The fllwing medicatins are apprved by the FDA t prevent and/r treat steprsis: Antiresrptive Medicatins Bisphsphnates Alendrnate and alendrnate plus vitamin D3 (brand names Fsamax and Fsamax plus D ). Alendrnate is apprved fr the preventin and treatment f steprsis in pstmenpausal wmen and fr the treatment f steprsis in men. It als is apprved fr the treatment f gluccrticid-induced steprsis in men and wmen as a result f lng-term use f sterid medicatins. Ibandrnate (brand name Bniva ).Ibandrnate is apprved fr the preventin and treatment f steprsis in pstmenpausal wmen. Risedrnate and risedrnate with calcium (brand names Actnel and Actnel with Calcium). Risedrnate is apprved fr the preventin and treatment f steprsis in pstmenpausal wmen and fr the treatment f steprsis in men. It als is apprved fr the preventin and treatment f gluccrticid-induced steprsis in men and wmen as a result f lng-term use f sterid medicatins. Zledrnic Acid (brand name Reclast ). Zledrnic acid is apprved fr the treatment f steprsis in pstmenpausal wmen. Other Antiresrptive Medicatins Calcitnin (brand names Frtical and Miacalcin ). Calcitnin is apprved fr the treatment f steprsis in pstmenpausal wmen wh are at least five years beynd menpause. Estrgen (multiple brand names available). Estrgen therapy (ET) and estrgen with prgesterne hrmne therapy (HT) are apprved fr the preventin f steprsis in pstmenpausal wmen. Accrding t the FDA, pstmenpausal wmen shuld cnsider ther medicatins befre taking ET r HT t prevent steprsis due t risks assciated

5 with these medicatins. They shuld als be used in the lwest pssible dse fr the shrtest perid f time t meet treatment gals. Estrgen Agnists/Antagnists als knwn as Selective Estrgen Receptr Mdulatrs (SERMs) Ralxifene (brand name Evista ). Ralxifene is apprved fr the preventin and treatment f steprsis in pstmenpausal wmen. Bne Frming (Anablic) Medicatins Parathyrid Hrmne Teriparatide (brand name - Frte ). Teriparatide, a type f parathyrid hrmne, is apprved fr the treatment f steprsis in pstmenpausal wmen and in men wh have very lw BMD r are at high risk fr a fracture. The FDA recmmends that individuals take teriparatide fr n mre than tw years. Tp f the page T learn mre abut steprsis, Awareness and Preventin Mnth, membership and mre, please cntact NOF at: Natinal Osteprsis Fundatin nd Street, NW, Washingtn, DC Phne: (202) Fax: (202)

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