1. Osteoporosis Daniel K. Park, MD

2. Osteoporosis Weakening of the bones

3. Osteoporosis Bone mass decreases after 35 yrs old 10 million Americans have it 34 million are at risk

4. Osteoporosis Women more at risk because bone loss occurs more rapidly after menopause 50% of women >50 yrs old will have fracture 25% of men >50 yrs old will have fracture 2005 2 million fractures $19 billion in costs

5. Common fractures Hip fracture Spine fracture Wrist fracture

6. Hip fracture Older women who have hip fracture have 2-3 fold increase in death in one year 1 month after surgery 10.5% 6 months 21.5% 1 year 27.3%

7. Spine fractures People at risk 6.6% in 1 year 16.9% at 3 years If already had fracture, 20% 23% are symptomatic fractures

8. Spine fractures

9. Wrist fracture

11. Risk Factors Genetics Lack of exercise Weight bearing exercise strengthen bones Too little Calcium and Vitamin D Smoking Excessive alcohol Low body weight Race White and Asians

12. Osteoporosis-signs You can have osteoporosis now or be at risk without realizing it If fracture, you HAVE osteoporosis Becoming shorter or more curve in your back

13. Diagnosis Bone mineral density test DEXA test

14. Treatment Make sure you take adequate Calcium and Vitamin D Bisphosphonates Fosamax, Boniva, etc Physical therapy to improve strength, balance, posture Stay active!!

15. Calcium

16. Sources of Calcium

17. Vitamin D Few food sources of vitamin D Fish best Salmon Tuna Milk, Eggs Impossible to get sufficient vitamin D from diet alone Best supplement is vitamin D3 CHOLECALCIFEROL 1-70 yrs old--600 IU/day >70 yrs old-- 800 IU

18. Vitamin D

19. Exercises