In a new report released today from the International Osteoporosis Foundation (IOF) women may be living longer but their quality of life can seriously be threatened if they do take action to protect their bone health.
Osteoporosis is a disease that thins and weakens the bones to the point that they become fragile and break easily. In the United States, more than 40 million people either already have osteoporosis or are at high risk due to low bone mass, placing them at risk for more serious bone loss and fractures. Osteoporosis has no signs or symptoms until a fracture occurs which is why osteoporosis is called a “silent disease”.
Around the world 1 in 3 women and 1 in 5 men over the age of 50 will suffer an osteoporotic fracture. In fact, a bone will break every 3 seconds because of this disease. For women the risk of a hip fracture is higher than the risk of breast, ovarian and uterine cancer. For men the risk is higher than prostate cancer.
Approximately 50% of people with one osteoporotic fracture will have another, with the risk of new fractures rising exponentially with each fracture.
The risk of enduring a factor increases with age due to the decrease in bone mineral density and increased falls among the elderly. As life expectancy increases the financial and human costs linked to osteoporotic fractures will dramatically increase. In 2005, $19 billion was spent treating incident fractures and prevalent fractures in the United States. Prevalence of osteoporosis in the United States is expected to increase to more than 14 million in 2020. By 2050 osteoporosis related costs are estimated to increase to $25 billion.
Professor John A. Kanis, Emeritus Professor in Human Metabolism, Director of the WHO Collaborating Centre for Metabolic Bone Diseases and President of the International Osteoporosis Foundation urged The time to act is now, those of us working in the non-communicable disease (NCD) community congratulated governments for their commitment to reduce the NCD burden by 25 per cent by 2025, at the World Health Assembly in 2012. As advocates for bone, muscle and joint health we have identified cost-effective evidence-based solutions that can be implemented immediately, which will not only save lives but reduce health care costs, and ultimately help governments reach this target."
According to the report postmenopausal women throughout the world are facing an ever increasing burden of responsibilities; as caregivers to the young and old, bread winners preparing for retirement and contributors to the welfare of the communities in which they live. For example, 70% of Spanish women over the age of 65 care for their grandchildren and 22% provide this care daily. In the United States, 75% of caregivers are women with 43% being at least 50 years old and 61% of family caregivers are women.
Dr. Bess Dawson-Hughes, MD, Professor of Medicine at Tufts University School Medicine and Senior Scientist and Director of the Bone Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging (HRNCA) at Tufts University and co-author of the report commented "Although the earlier prevention begins the better, when a woman reaches menopause she must not delay any longer. Menopause is the critical time to take preventive measures against bone loss and muscle weakness that can lead to osteoporosis, falls and fractures.”
Bone is a living tissue which regenerates itself throughout life thanks to a fine balance of bone breakdown and formation. However, during menopause bone breakdown surpasses bone formation which leads to a rapid decline in bone mass. An increase of bone loss can lead to osteoporosis.
Fractures can exact a terrible toll on the quality of life of postmenopausal women across the world. Fractures account for more days in the hospital than many other diseases including diabetes and breast cancer.
Another important message in the report is secondary fracture prevention. Professor Cyrus Cooper, MA, DM, FRCP, FFPH, FMedSci, Chair-Elect to the Norman Collisson Chair of Musculoskeletal Science at the University of Oxford; Chairman of the Committee of Scientific Advisors, Associate Director of Research at the University of Southampton Medical School, Associate Editor of Osteoporosis International and Chairman of the Committee of Scientific Advisors, International Osteoporosis Foundation, commented "An individual who has experienced a fracture is at double the risk of suffering a second fracture as compared to a person without fractures. In postmenopausal women, a broken wrist or a spinal fracture is often the harbinger of more fractures to come and should be taken as a warning that testing and preventive treatment is needed. Given that 20 per cent of those who suffer a hip fracture die within one year, it is not only unacceptable but unjust not to take action to change this.”
The report also includes how to reduce fracture risk including exercises to build strong bones. The report also notes that two meta-analyses had reported that a prior fracture at any site is linked with double the risk of a future fracture. Medications, family history, diseases of malabsorption such as Crohn’s disease, rheumatoid arthritis and early menopause also increase the risk of fractures.
The FRAX® tool has been developed by WHO to evaluate fracture risk of patients. It is based on individual patient models that integrate the risks associated with clinical risk factors as well as bone mineral density (BMD) at the femoral neck.
The International Osteoporosis Foundation’s fact sheet “Bone Care for Postmenopausal Women “can be viewed online.