Dr. Marla Shapiro: The Osteoporosis Care Gap
Education and Advocacy Osteoporosis is a significant health concern affecting one in four women and one in six men worldwide.
In women the lifetime risk of a hip fracture over the age of 50 is 12.1 percent. We know that a fracture precipitates another fracture in that 40 percent of women with a hip fracture have had a prior fracture. These women are also more likely to have a deteriorated quality of life — 40 percent need assistance with walking. What is even more alarming is that 23 percent of women with a hip fracture will die within a year. While more men are less likely to sustain a hip fracture — their one-year mortality rate is even higher, at 37 percent.
Despite the fact that we know a history of a fracture is the strongest predictor of new fractures, individuals who have sustained a fracture over the age of 40 are typically not treated. In fact only 15 percent actually get treated for their recurrent risk of fracture.
It is important to understand that a fracture after the age of 40 is often what we refer to as a fragility fracture. What does that mean?
Often a patient will tell me that it was icy and they slipped and landed hard and somehow, the belief is that the nature of the fall is what caused the fracture. What is important to understand is that a fragility fracture is a bone break that happens after a minor trauma such as falling from a standing height or falling from a sitting position, falling from a prone position, falling after missing 1 to 3 steps in a staircase, or even after a movement different than usual. A fragility fracture can even happen with coughing.
The fracture tells us that the bones are more likely to have fractured because of their innate strength or lack of it.
Screening your bone health
After the age of 50 it is important for both men and women to be screened for bone health. Telling your doctor if you have broken any bones, have a history of falling, or have prolonged or unusual back pain is important, as these may be clues to your bone health. Has your back become more curved? Do you have difficulty getting out of your chair if there are no arms to hang on to?
It is important to have your height and weight measured at each medical visit. While we recommend a baseline bone density test for all at age 65, your doctor will determine whether or not you should have one before age 65.