Posted on 12/26/2007 8:55:51 PM PST by neverdem
Largest, longest study ever supports screening and prevention of osteoporosis.
One bone mineral density test can accurately predict a woman's chance of spinal fractures 15 years down the line, new research shows.
And, according to the largest and longest prospective study of osteoporosis ever, women who had a spinal fracture at the beginning of the study had four times the risk of sustaining another fracture later on.
The bottom line: "Women need to talk to their doctors about the risk of osteoporosis," according to Jane Cauley, lead author of the study and professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.
Her team published the findings in the Dec. 19 issue of the Journal of the American Medical Association.
"I agree with the guidelines that all women after the age of 65 have bone density tests, and Medicare will pay for that," Cauley said. "Women who are postmenopausal, 50 to 64 years of age, should consider having a bone density test if they have other risk factors for osteoporosis or if they want to know what their bone density is before they consider any other treatment."
The findings don't change current standard practice, experts said, and they don't change the basic message to women: Don't ignore bone health, especially in middle and old age.
"The only really major advance here is that it's a longer term study. Mostly studies are five years typically. This one went out 15 years," said Paul Brandt, associate professor of neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine in College Station. "Women need to get their bone mineral density tested after they start menopause and if they stay on hormone replacement therapy or an anti-osteoporotic treatment." he said.
Postmenopausal women are particularly vulnerable to fractures resulting from osteoporosis, a degenerative weakening of the bones. Some 10 million Americans, including one in five American women over the age of 50, suffer from osteoporosis, which is the most common type of bone disease.
Spinal fractures are the most common type of fracture resulting from osteoporosis, affecting 35 percent to 50 percent of women over 50 (about 700,000 vertebral fractures annually in the United States).
But many, if not most, of these fractures go undetected. "Osteoporosis is sometimes called the silent thief," Cauley said. "It basically robs the skeleton of strength and resources, and women don't really know about it. About 75 percent of all spine fractures actually occur silently."
"Identifying risk factors for spine fractures is less well developed. You have to systematically look for them by repeated X-rays," Cauley continued.
The findings from this study are based on bone mineral density data from 2,300 women over the age of 65 who enrolled in the Study of Osteoporotic Fractures (SOF), initiated in 1986.
After 15 years of follow-up, it was evident that 25 percent of women who had low BMD at the beginning of the study developed fractures of the spine, compared with only 9 percent of women with normal BMD.
"It was pretty much a strong gradient of risk," Cauley explained. "If you had normal bone density when you entered and did not have an [existing] fracture, the risk of having a new spine fracture was about 9 percent, compared to a risk of 56 percent in women who had osteoporosis and who had an existing fracture. So, the range of risk varied dramatically depending on bone density and previous spine fractures."
According to Brandt, one interesting finding from the study is that a previous vertebral fracture topped even bone mineral density as a predictor for future fracture.
This indicates that women with an existing vertebral fracture should be treated for osteoporosis regardless of their BMD, the authors reported.
"People think osteoporosis is an inevitable consequence of aging, but it is preventable and treatable," she said.
More information
There's more on age-linked bone loss at the U.S. National Library of Medicine.
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Maybe 5, 10 years ago, there was a segment on women’s bone density
and fractures on one of the major network news shows.
One of the “example” ladies that got a bone density scan was a
“very fit”, “daily exercising” lady that appeared to live on a diet
of air, a few vegetables, and Diet Coke.
The doctor, in a sad and shocked tone told the young lady (in her
early 30s?) that the bone-density scan showed she “had the bones of
the average 80-year-old female”.
IIRC, the scans were shown and they simply had a bunch of “pinholes”
in them...looked like the osteo-version of Swiss cheese.
When I looked it up on line, it was suggested that 40 million women have that condition. If you do the math, that’s about the same number of women who have grey hair...
Of course the first thing the Dr. wanted to do was to prescribe medication. It seems to me that before you take medicine (which has side effects, the Dr. should make sure the patient is getting the right amount of nutrients (calcium etc.), but of course they don’t make any money that way.
Their all a bunch of crooks in my book.
Get your wife some Lemon Flavored Carlson’s Cod Liver Oil.....she probably needs more Vitamin D.....lots more.
Women with strong bones have fewer fractures. Now, for my next grant proposal, this finding needs to confirmed for men.
“she probably needs more Vitamin D.....lots more”
Thanks. I told her that. She is one of those people that are afraid of the sun. She’s taking calcium now with vitamin D.
Okay...smarty pants....HOW do they GET or keep “strong bones?”
Nothing can be done. It's like the Presbyterian Doctrine of Predestination...you go to heaven or you don't, no matter what you do here on earth.
Nothing? Not exercize, or calcium?
I'd be real careful with that suggestion. VitD doesn't have as strong a role in absorbing calcium as many believe: The major receptor-dependent actions of 1,25-dihydroxyvitamin D on skeletal development are indirect and are a reflection of the role of this hormone on intestinal calcium absorption.
And large doses of VitD are problematic: Hypercalcemia due to vitamin D intoxication with clinical features mimicking acute myocardial infarction.
and more to the point, the active form of Vitamin D (1,25D) is known to destroy bones: this dysregulated vitamin D conversion can mean that even a moderate intake of vitamin D through ingestion or solar exposure can cause the 1,25D hormone to become high enough to stimulate osteoclastic action
"As people reach old age"
Are you trying to say that I'm OLD? LOL ;o)
Sorry....don’t believe you that “nothing can be done.”
See post 11..
My last dexascan gave -1.6 std dev, which is on the edge of osteoporosis. This is the result of 25 years of sarcoid & 12 years of using prednisone (the doc's took a long time to find the sarcoid).
To cure the sarcoid, I'm doing the Marshall Protocol, and it's working. Bone density seems to be one of the last things to get fixed, but the rate of bone loss has slowed for me. Others have seen their bone density go back to normal.
The MP understanding of the science of Vitamin D and bone loss is explained here: Don't I need vitamin D to prevent bone loss?
I'd bet good money that folks who are 'afraid of the sun' have the experience that they just don't feel good the day or week after going out in the sun. I know that's how it worked for me.
Tongue-in-cheek comments fly right by you, don't they?
Well....tests SHOULD be run on someone’s Vit D (1, 25 Dihydroxy).....BUT, overdosing on Vit D requires the taking of quite a bit more than just a little Vit D in a combo pill with calcium, that’s fer sure!
If “their” all a bunch of crooks, why do you let “you’re” wife be diagnosed by a crook?
I suppose you think each doctor owns his/her own drug company and only prescribes drugs from “their.” It’s all a racket - no one could possibly have “they’re” patients’ interests at heart. Good luck with that attitude.
You always have to pay the Piper...
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