Definition: Osteoporosis means “porous bones”. It is a disease where there is less bone and less quality of bone. Therefore, the risk of fracture increases and this is why it is so important to diagnose this condition and manage it appropriately.
Why we are concerned about osteoporosis: Usually, there are not any symptoms that someone is losing bone. Often, the first symptom is a fracture. Therefore, someone can be losing bone and not be aware of it. The goal is to recognize who should be tested for osteoporosis, decrease fracture risk and ultimately, decrease fractures, by managing their bone health.
Who is affected: Osteoporosis affects both men and women and can start at any age. Osteoporosis is actually called “A pediatric disease with geriatric consequences” which underscores the importance of activity and proper nutrition during the crucial growth years of children. Developing strong bones in childhood is one of the best ways of decreasing fracture risk in adulthood.
What is a “Fragility Fracture”? A fragility fracture is also called a “low trauma fracture” and is a fracture that is caused by a fall from a standing height or missing the last few steps on the stairs. If you have a fracture, speak to your Doctor about whether this was an “abnormal force on a normal bone” or a “normal force on an abnormal bone”. If this seems to be a “normal force on an abnormal bone, then you will want to be assessed for osteoporosis.
How is osteoporosis diagnosed: A Bone Mineral Density Test is the preferred method for diagnosis. This is performed on a machine called a dual energy x-ray absorptiometry, otherwise known as “DXA”. There is very low radiation associated with this test and it is about equal to the amount of radiation when flying from Vancouver to Toronto.
This test provides a “T-score”: a number that tells you how your bone density compares to an average young adult. It is normal to have some bone loss with aging, but a Bone Mineral Density test will determine if you are losing more bone than you should be.
According to the World Health Organization (WHO)
- A T-score of -1.0 or above is normal bone density. Examples are 0.9, 0 and -0.9.
- A T-score between -1.0 and -2.5 means you have low bone density or osteopenia. Examples are T-scores of -1.1, -1.6 and -2.4
- A T-score of -2.5 or below is a diagnosis of osteoporosis. Examples are T-scores of -2.6, -3.3, and -3.9
- The lower a person’s T-score, the lower the bone density. A T-score of -1.0 is lower than a T-score of 0.5 and a T-score of -3.5 is lower than a T-score of -3.0.
World Health Organization
About osteopenia: Some people say “I just have osteopenia”. However, fractures also occur in people with osteopenia and it has been estimated that as many as 50% of fractures occur in people with osteopenia.
Facts and Statistics:
- 1 in 3 women and 1 in 5 men are at risk of an osteoporotic fracture.
- An osteoporotic fracture is estimated to occur every 3 seconds in the world.
- Osteoporosis affects over 2 million Canadians.
- Fractures from osteoporosis are more common than heart attack, stroke and breast cancer combined
- Over 80% of all fractures suffered by people 50 years of age and over are caused by osteoporosis
- Women approaching menopause can lose bone at a greater rate (2 to 3% per year)
- Few patients who have suffered a fracture (less than 20%) undergo diagnosis and adequate treatment for osteoporosis
(International Osteoporosis Foundation and Osteoporosis Canada)
Summary: The goal of osteoporosis management is to prevent fractures and, if someone has suffered an osteoporotic fracture, the next step is to prevent another one. Key management strategies include bone healthy nutrition, bone healthy exercises and proper body mechanics. Doctors will also evaluate patients to determine if osteoporosis medication is indicated to decrease risk of fracture