Evaluation of osteoporosis risk factors and recommendations for prevention

Osteoporosis is a skeletal disorder characterized by low bone mineral density (BMD) that leads to bone fragility and an increased risk of fracture. In Canada, it's estimated that 1 in 4 women and 1 in 8 men have osteoporosis. Due to its frequency, osteoporosis is a major health concern, particularly for the elder community, as it's associated with loss of independence, increasing health care costs, and mortality rates.

Who's at risk?

The organization Osteoporosis Canada has presented the following major factors to determine who should receive BMD tests to assess osteoporosis risk:

• Age over 65
• Fragility facture after age 40
• Family history of osteoporotic fracture (especially maternal hip fractures)
• Systemic glucocorticoid therapy of more than three months

Common recommendations to reduce osteoporosis

Osteoporosis Canada provides a number of evidence-based recommendations for physicians to help prevent osteoporosis. For pharmacological physicians, hormone therapy and bisphosphonates are two of many supplemental recommendations designed to prevent bone loss and fracture. Physical therapists can also play a positive role toward improving BMD and reducing fracture risk by prescribing exercise and activity programs. Therapists can instruct effective lifestyle changes, which can have a direct and rapid impact on improving bone health. The following interventions can yield great benefits for osteoporosis candidates:

• Follow a specific daily walking regimen including duration and intensity (benefits hip BMD; may reduce fracture risk)
• Use resistive exercise to be performed three times/week (builds strength; may have impact on BMD and fall reduction)
• Develop competence in balance exercises (can reduce falls; may have direct impact on fracture reduction)
• Take dietary supplements with any medications prescribed (routine supplementation of 1000mg/day of calcium and 800 IU /day of vitamin D is great adjunct to pharmacological interventions)
• Limit caffeine intake to no more than four cups of coffee/day (more is associated with increased fracture risk)
• Stop smoking (smokers have lower BMD than non-smokers, but can change that)

-As reported in a Feb. '06 report from The Journal of Obstetrics and Gynecology Canada (JOGC)

-Summarized by Greg Gargiulo