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Osteoporosis is the most common bone disease and is twice as common in women as in men.
People with osteoporosis have thinning of their bones, causing their bones to become fragile and to fracture (break) easily. Most people do not know they have osteoporosis until they fall and break a bone, usually their spine, wrist, or hip. However, you can find out if you have osteoporosis by having your bone mineral density (BMD) measured.
Osteoporosis is a serious disease. Half of women past menopause and older than 50 years will have a fracture due to osteoporosis. Hip fractures are a major cause of disability among older people. Women also may become disabled from kyphosis (a “dowager’s hump”).
Testing and Diagnosis
Bone mineral density is measured with a low-cost, low-risk DEXA (bone) scan. Because age is also a major factor in risk of breaking a bone, it is important to consider both BMD and age when deciding how often to be tested. Your doctor can use an online tool called a FRAX calculator to help with this treatment decision.
Results of BMD measurement can show if a person has either osteopenia (mild low bone density) or osteoporosis (severe low bone density).
Prevention and Treatment
There are many causes of osteoporosis. Some cannot be controlled or changed. These include
White or Asian race
Confinement to bed
Certain diseases or medications
However, lifestyle changes that help you stay healthy in general can also help protect you from developing osteoporosis, including
Not smoking cigarettes
Eating foods with plenty of calcium and vitamin D, including dairy products, kale, broccoli, canned salmon, and sardines
Regular weight-bearing exercise such as walking, dancing, or climbing stairs
Eating enough to avoid being underweight
Doctors may prescribe medication for osteoporosis, in pill form or given as a shot. All medications may have side effects, some of which can be bothersome. However, medications can prevent about half of fractures in people who have osteoporosis. Most people with osteopenia need to develop good health habits and have follow-up appointments but do not need prescription medicine.
The National Institutes of Health is funding studies to determine the best kind of vitamin D and calcium supplements. Current vitamin D recommendations for adults are at least 600 units per day for people aged 70 years or younger and at least 800 units per day for those older than 70 years. A total calcium intake of 1200 mg per day is recommended, with as much as possible coming from food.
National Institutes of Healthnihseniorhealth.gov/osteoporosis/whatisosteoporosis/01.html
US Preventive Services Task Forcewww.uspreventiveservicestaskforce.org/uspstf12/vitamind/finalrecvitd.htm
National Osteoporosis Foundationwww.nof.org
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at jama.com. Many are available in English and Spanish.
Sources: National Institutes of Health, US Preventive Services Task ForceFerri’s Clinical Advisor. Philadelphia, PA: Mosby Elsevier; 2014:810.
Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Topic: Bones, Joints, and Muscles
Sugerman DT. Osteoporosis. JAMA. 2014;311(1):104. doi:10.1001/jama.2013.283009
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