Osteoporosis is a preventable disease in which bones become less dense and more fragile. Most people don’t know they have this disease until they break a bone.

Osteoporosis can affect you in many estrogen, can lose up to 20% of their bone ways. Most commonly, broken bones mass. One in 2 women and 1 in 4 men (fractures) occur in the hips, spine, and older than 50 will have an osteoporosis-wrists. Any bone can be affected, but of related fracture in their lifetime. special concern are the hip and spine.

A hip fracture almost always requires hospitalization and major surgery. Hip fractures impair a person’s ability to walk unassisted and may cause prolonged or permanent disability. One quarter of people with hip fractures require long-term care, and another quarter die within one year after the break. Although hip and wrist fractures most often occur when a person falls, spinal fractures can happen without any trauma. Spinal bones (vertebrae) may collapse and initially cause severe back pain, loss of height, or spinal deformities, such as a stooped posture.

Who’s at risk?

Millions of Americans older than 50 are at risk. Women, who are at greatest risk after menopause due to reduced levels of estrogen, can lose up to 20% of their bone mass. One in 2 women and 1 in 4 men older than 50 will have an osteoporosisrelated fracture in their lifetime.

A lesson in prevention

Preventing osteoporosis is very important, as there is no cure for the disease. Osteoporosis is often called a “silent disease” because bone loss occurs slowly over time without symptoms.Following are steps that can be taken to prevent bone loss or slow its progress.

Diet. Calcium and vitamin D help to build and strengthen bone. A deficiency in these nutrients increases the risk of osteoporosis in older people. A balanced diet rich in calcium and vitamin D reduces the risk of bone loss.

Exercise. Weight-bearing exercise is a ?good way to make bones stronger. Examples of such exercise include walk-ing, jogging, dancing, stair climbing, hiking, low-impact aerobics, and ten-nis. Swimming and stretching are not weight-bearing exercises and may not have the same beneficial effect on your bones. (For another exercise option, see page 21.) Speak with your doctor before beginning any exercise regimen.

Quitting smoking and cutting alcohol intake. Smoking a pack of cigarettes a day throughout adult life is associated with loss of 5% to 10% of bone mass. In women, smoking decreases estrogen levels and can lead to earlier menopause and bone loss. Regular consumption of alcohol may increase bone loss as well.Quitting smoking and limiting alcohol intake help preserve bone mass.

Bone mineral density testing. The National Osteoporosis Foundation rec-ommends bone density testing for people 65 and older. Bone density tests can diag-nose osteoporosis and determine your risk of fracture. Moreover, your need for medication can be evaluated. The most useful test is dual-energy x-ray absorpti-ometry (DEXA). It is non-invasive and
painless.

Medications.Medications to prevent and/or treat osteoporosis include bisphos-phonates, calcitonin, estrogens, parathy-roid hormone, and raloxifene. If after test-ing it is determined that you need drugs, your doctor will explain your options and how dosing may affect your lifestyle. Different medicines are available in daily, weekly, or monthly doses.

Preventing falls. Create a safer environ-ment to avoid common household acci-dents. For example, eliminate any tripping hazards in your home, and leave a night-light on in the bathroom.

Staying with it It is important that you stay with the plan on which you and your doctor have agreed. Most people cannot feel their bones getting stronger or weaker, so discuss your concerns with your doctor before stopping or interrupting treatment. Failure to stick with any one of the steps may reduce your chances of preventing osteoporosis-related fractures.

From The Lancet, the American Medical Association, and The American Journal of Medicine