Is Osteoporosis a Senior Health Crisis?

Osteoporosis is a “silent” disease. That means that it happens in the body so gradually that you don’t notice it is occurring until something drastic happens – and in the case of osteoporosis, that usually means a broken bone. By the time a senior is diagnosed with osteoporosis, bone density has decreased significantly, making bones brittle and more prone to breaking under even slight pressure. Therefore, if an elderly adult suffers a fall, the odds of getting seriously injured are much higher than they were years ago.

Did you know that 50 million Americans are at risk of developing osteoporosis, and 10 million already have it? Eight million of those – or 80% - are women[1]. According to the National Institute on Aging, osteoporosis mostly affects those over the age of 50 and the risk gets higher as you get older.  And 44 million Americans have low bone density, which puts them at a greater risk of developing osteoporosis in the coming years[2].

What exactly is osteoporosis? The NIH Osteoporosis and Related Bone Diseases National Resource Center defines it as “a bone disease that develops when bone mineral density and bone mass decreases, or when the structure and strength of bones change.”

To put that in perspective, it’s important to remember that bone is living tissue. Throughout our lives, bone slowly breaks down and is replaced with new bone. If you were to look at a cross-section of your bones, they would look surprisingly like honeycombs – the bone is porous but still sturdy and strong. As we get older, bone continues to break down but isn’t replaced as quickly as it used to be. The result is that the spaces in that “honeycomb” get larger and the outer shell of the bone gets thinner, which means weaker bones that are much more prone to fracture.

Why is Osteoporosis a Senior Health Crisis?

Osteoporosis is much more serious than you might think. The Bone Health and Osteoporosis Foundation reported that in 2016, about 1.8 million individuals on Medicare sustained 2.1 million fractures related to osteoporosis. However, only 9% of women and 5% of the men who sustained fractures had been screened for osteoporosis in the previous six months, suggesting that screening for bone density isn’t happening nearly enough.

And that’s a serious problem, especially since new studies have found that the incidence of hip fractures is expected to almost double across the world by 2050[3]. Hip fractures are very serious:

·         Among those who are over 50 who break their hip, 50% never walk independently again, 20% wind up in a nursing home for more intensive care, and 25% die in the year following their injury[4].

·         Fractures from osteoporosis lead to more hospitalizations among women aged 55 and older than heart attacks, strokes, or breast cancer[5].

·         A woman’s risk of fracturing a hip due to osteoporosis is equal to the risk of breast, uterine, and ovarian cancer combined[6].

The economic impact of osteoporosis is also a concern. It cost $57 billion to treat osteoporotic fractures in Medicare beneficiaries in 2018, and that cost is expected to go up to more than $95 billion by 2040. But remember our earlier mention of those bone density scans, and how few seniors are getting them? The Medicare beneficiaries who do get them sustain 35% fewer hip fractures than those who don’t[7].

As the population ages at a rate of more than 10,000 baby boomers hitting 65 every single day, the rates of fractures from osteoporosis will certainly go up. And by 2030, when the last of the baby boomers have become senior citizens, the societal cost of fractures – not to mention the personal toll the injury takes on family caregivers, medical teams, and the seniors themselves – will be higher than ever[8].

What can you do to avoid becoming a statistic? Learning about osteoporosis, and getting screened for it when appropriate, are two of the best defenses.

Who is at Risk for Osteoporosis?

It’s already clear that women are at the greatest risk for osteoporosis (though men are not immune – one in 20 men will develop the disease). Other risk factors can include[9]:

·         Being of White or Asian descent

·         A family history of the disease or of broken bones

·         A broken bone after the age of 50

·         Insufficient amounts of calcium, vitamin D, and protein

·         A sedentary lifestyle or long periods of bedrest

·         The use of cigarettes or alcohol

·         Altered hormone levels, including too little estrogen for women or too little testosterone for men

·         Long-term use of some medications, such as corticosteroids, antiepileptic drugs, or proton pump inhibitors

·         Ovaries surgically removed before menstruation ceased naturally

Of course, the risk of osteoporosis grows with age. After menopause, women lose bone mass quickly for several years until the loss tapers off. By the age of 65 or so, men and women lose bone mass at the same rate. But the situation is more serious for women because men tend to have higher bone mass density to begin with, and so can tolerate the loss easier than women can[10].

How to Avoid Osteoporosis

The best way to avoid problems with bone density and fractures is to do what it takes to avoid those fractures in the first place. While good fall prevention is key to longevity for the elderly, keeping your bones strong is good way to make sure that if you do fall or have a physical accident, you run a smaller risk of getting seriously hurt. Here are some potential ways to prevent osteoporosis:

·         Eat the right foods. Calcium, vitamin D, and protein are essential to good bone health. You can get these from sources like leafy green vegetables, fish, low-fat dairy, and fortified cereals, juices, grains, and milk. Your doctor might recommend supplements if you are at higher risk of osteoporosis, but don’t let those supplements be a substitute for a healthy diet.

·         Get the right exercise. The CDC suggests 150 minutes of exercise each week, which breaks down to about 30 minutes a day. Weight-bearing exercises, such as hiking, walking, climbing stairs, dancing, tennis, and strength training are more likely to strengthen your bones.

·         Stop smoking. Smoking affects everything about the body, including the bones. Smoking can increase the risk of thinner bones, which can make it more likely you will suffer a fracture[11]. If you need help to stop smoking, talk to your doctor about cessation programs.

·         Limit alcohol. Just as smoking can make your bones thinner, so can drinking too much alcohol[12]. If you do choose to drink, do so only in moderation.

Though fall prevention measures don’t prevent osteoporosis, they can help you avoid the worst consequences of the disease, which is falling down and sustaining a painful fracture that will be difficult to heal.

Whether you are on the go or at home, a medical alert watch or pendant is a good idea to provide the peace of mind you need. If you do suffer a fall or other emergency, these medical alert devices can allow you to get immediate help at the touch of a button.

How is Osteoporosis Diagnosed?

The U.S. Preventative Task Force recommends that women over the age of 65 be screened for osteoporosis, and younger women who have gone through menopause should be screened if they are at greater risk. There is no recommendation for men to be screened, as they lose bone density much more slowly than women do. However, there is still a risk, so men should speak to their doctor about what they should do to prevent the problem.

Screening is done with a bone density scan. This test can determine how a senior person’s bone density compares to that of a healthy young adult. The rate of bone density loss is known as a T-score. Other screening tools help doctors make a diagnosis, including physical exams, questionnaires about your life, and ultrasounds.

If your doctor diagnoses you with osteoporosis, the good news is that now you can do something about it. Lifestyle changes, such as taking supplements and exercising regularly, can help. Your doctor might also choose to put you on medications. These can slow down bone loss or help rebuild bone.

If you are diagnosed with osteoporosis, fall prevention will be one of the key points your doctor talks about with you. Keeping your home neat and clear of clutter, using the devices that are intended to help you avoid falls (such as a walker or cane if they are recommended), or even holding onto grab bars as you get in and out of the shower can make a world of difference. It’s also a good idea to consider an emergency response solution that you can wear at home or on the go. This can help you reach out for assistance right away if you suffer a fall or other emergency.

What to Do If You Get Injured in a Fall

Osteoporosis can be severe enough to lead to serious fractures as a result of things you never dreamed might cause it. Stretching a bit too far during a workout, bending to touch your toes, bumping into the kitchen table, or even coughing can lead to a fracture somewhere in the body[13]. In addition to that, overcoming the injury can be much more difficult for someone with osteoporosis, as their bones don’t heal as quickly as they do for someone without the disease[14]. So it’s safe to say that a fall can be devastating for those with osteoporosis.

If you suffer a fall, it’s important to get help immediately. You might be disoriented, dazed, and in pain in the aftermath of a fall, especially if you have broken a hip or other bone. That’s when a medical alert system could save your life.

Reaching out for help right away can help you avoid the consequences of what scientists call the “long lie.” The term refers to the time an elderly person spends lying on the floor after a fall while they wait for help to arrive. Without medical alert technology, that time could be quite long, and that could lead to pressure sores, muscle breakdown, hypothermia, dehydration, and more[15].

If you opt for a medical alert system with fall detection, you’re in even better shape. When you suffer a fall, the tiny fall sensors in the device can recognize what has happened and send an alert without you even having to press the button. Whether you are diagnosed with osteoporosis or not, that’s invaluable peace of mind as you age in place.