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Loss of Inches…Osteoporosis

For avid readers of the column you’ll say, wasn’t this topic covered already? Yes it was… however, it was based on the general condition, whereas I’m covering the specific area of Loss of inches and its effects. A female senior very recently came to the Clinic with severe foot issues, the result of diagnosed loss of inches, which prompted the article, given her challenges.

We oft times hear people say it, or we may watch persons we know, mainly women over a certain age, and say they look like they have gotten shorter. It can in fact happen, people do lose inches. Osteoporosis was viewed as a condition that afflicts only women, but men are also susceptible to the bone loss that accompanies advanced aging. Osteoporosis is caused by gradual bone loss that accompanies advancing age. The amount of bone we have in our body is determined by genetic factors, calcium intake and how much we exercise during our growing years. Total bone mass reaches a maximum in our early 20s, remains constant for about 30 years, and then gradually declines.

The Effects

Stages of loss of height

The loss of 2 or more inches in height during adulthood serves as a powerful predictor of osteoporosis in the hip, and thus the risk for hip fractures, in elderly women. Studies have pointed out that a fracture of the hip caused by osteoporosis should be preventable, if monitoring of changes in height by primary care physicians is done.  Such action could reveal the need for bone density testing at a much earlier stage in the bone loss progression.

Osteoporosis is a disease that causes the skeleton to weaken and the bones to break. Results of a study showed that height loss of between 2 inches and 3 inches, increased more than fourfold the chance the women had osteoporosis of the hip (verified by bone density testing). Odds of osteoporosis in the hip were nearly 10 times greater in women with 3 or more inches of height loss, compared to women with less than an inch of loss. The average age of the women in the study was 60. All were post-menopausal, when the lack of estrogen production can lead to dramatic bone loss.

Often called a “silent disease” because most patients feel no symptoms, osteoporosis is often not diagnosed until a fracture has occurred. An estimated 30 million American women either have, or are at risk for it, with about 300,000 hip fractures occurring annually. Men account for 25 percent of the hip fractures nationally.

A significant threat to more than 2 million men in the United States, after age 50, 6% of all men will experience a hip fracture and 5% will have a spine fracture. Statistics indicate that about 2 million men have osteoporosis, and another 12 million have a low bone mass, which places them at great risk of developing the disease. Approximately 13 percent of men will suffer a fracture caused by osteoporosis, and all the fallouts such as chronic pain, improperly healed limbs, compromised mobility, and ability to do daily activities.

Despite these facts, a majority of men view osteoporosis solely as a woman’s disease. Moreover, among men whose lifestyle habits put them at an increased risk, few recognise the disease as a significant threat to their mobility and independence.

Broken hips can be catastrophic for elderly patients – nearly 50 percent of sufferers never return to normal function; 25 percent require nursing home care; while 20 percent die of infection, blood clots, or other complications within six months after the fractures.

Broken Ankle

Treatment / Prevention

Treatments for osteoporosis focus on maintaining or building strong bones. However, building of bones, especially before the age of 35 and maintaining a healthy lifestyle are the best ways to prevent osteoporosis. To build as much bone mass as early as possible in life, and to help slow the rate of bone loss later in life, doctors advise:

·         Following a healthy diet, that is, low in fats, animal products, whole grains and fresh fruits

·         Getting calcium from foods such as dairy products, dark-green leafy vegetables, sardines, salmon, and almonds

·         Taking nutritional supplements like calcium, magnesium, & Vitamin D

·          Avoiding smoking and alcohol

·         Doing weight-bearing exercises.

Prognosis

There is no cure for osteoporosis, but it can be controlled. Most people who have osteoporosis fare well once they receive treatment. The medicines available now build bone, protect against bone loss, and halt the progress of this disease.

In the future, bone density screening may become routine as mammograms for women who have reached menopause. Until that happens, monitoring height should be a part of every check up after the age of 50.

There is no consensus as to when a man should be screened for osteoporosis. In women, bone density tests to identify osteoporosis are recommended at menopause and every few years thereafter.

                            

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