All of reasonably well-informed Americans are quite aware of the fact that old people, and especially old ladies are quite prone to broken wrists, hips and spine. The fear of suffering one of these fractures results in most elderly ladies not getting enough exercise to maintain good health.
Recent studies have shown that 55% people age 50 and older have osteoporosis. Half of all women who have osteoporosis will experience a fracture resulting from demineralized poor quality bone. ? of men in the same age group will sustain a fracture. It is estimated that about 1.5 million osteoporosis fractures occur each year in this country. It costs about $14 billion each year to treat these fractures. This is a major public health problem.
Why does bone become more fragile with age? To understand this a brief review of bone physiology is necessary. All bone is living tissue, which has the ability to repair itself after injury and to respond to alterations in the stress it is subjected to. The cells that build bone are known as osteoclasts, the cells that tear down and get rid of bone are osteoblasts. Up until about age 23 bone is formed and built more rapidly than it is done away with. The quality and density of bone laid down during childhood and young adult life has a great effect on the strength and durability of bone for the rest of one’s life. Coke and a candy bar for a noon meal (after skipping breakfast) with another carbonated beverage and a burrito or spaghetti for supper plus a couple of cookies over several years of time is almost a guarantee for osteoporosis and fractures in later life. If one combines this diet with a minimum of exercise, which is easily achieved by playing video games and watching TV, a person is sure to end up paying significant money to the orthopedic surgeon who will fix the fractures resulting from poor quality bone.
Maintaining a habit of regular exercise helps prevent osteoporosis. Incidentally weight lifting and yoga don’t help maintain bone mineral mass, which is essential in maintaining healthy bones. Nothing beats walking or running. For instance, golf is great as long as one does not use a golf cart. Alcohol and tobacco both enhance the loss of bone mass.
Treatment hopefully before one sustains a fracture in addition to those thing mentioned consists of some nine different medications now on the market. They all work, none are cheap and they are usually well tolerated. The problem is that just as osteoporosis takes a long time to develop it takes a long course of treatment to cure the disease, and a large proportion of those on medication tend to loose interest and stop taking the medicine. After being on the drug for one year only 47% were still taking the medication. However, that 47% that complied with treatment actually demonstrated 25% fewer fractures than those who stopped treatment.
There is no substitute for exercise and a proper diet!
Richard S. Buker, Jr., M.D.
