2. Prevent Osteoporosis… GET “BONE” HEALTHY KENTUCKY

3. SPONSORED BY: Kentucky Department for Public Health Osteoporosis Prevention and Education Program

4. PRESENTED BY:

6. What Is Osteoporosis ? What Happens When Bones Break ? How Common Is It ? What Are The Risk Factors ? Steps To Prevention Bone Density Testing Treatment Options Fall Prevention Summary

7. WHAT IS OSTEOPOROSIS ? Osteo = bone Porosis = full of holes Osteoporosis = means bones that are full of holes

8. Normal Bone

9. Osteoporosis

10. NORMAL HEALTHY BONE OSTEOBLASTS OSTEOCLASTS

11. OSTEOPOROTIC BONE The loss of living bone tissue makes bones fragile and more likely to fracture.

13. Women: Role of Estrogen Hormone that protects against bone loss After menopause, estrogen production decreases – may lead to rapid bone loss Rate of Bone Loss in Postmenopausal Women –1% to 2% annual loss for 10 years after menopause –Fastest in first 3 to 6 years

14. WHAT HAPPENS WHEN BONES BREAK

15. Osteoporosis When Bones Break The most common breaks in weak bones are in the: –Wrist –Spine –Hip If you break a bone after the age of 50, talk to your health care professional about measuring your bone density

16. Osteoporotic Spine Fracture Normal Compressed bone Fractured

18. Osteoporosis When Bones Break Hip fractures are the most devastating –One in five elderly people die within a year of the fracture –One in five must move to a nursing home within a year –One in four become disabled –Many become isolated and depressed

19. Did you Know? Someone with osteoporosis may have weakened jawbones and be prone to losing teeth Recent studies show women with osteoporosis have been reported to have 3 times more tooth loss than women without the disease.

20. HOW COMMON IS OSTEOPOROSIS?

23. KENTUCKY STATISTICS (2002) Projections for 2010 834,000 Kentuckians age 50 & over will be affected. National Osteoporosis Foundation Women 128,000 osteoporosis 342,000 low bone mass Men 37,300 osteoporosis 223,400 low bone mass

24. RISK FACTORS

25. Are You at Risk for Weak Bones? Check Any of These that Apply to You  I’m older than 65  I’ve broken a bone after age 50  My close relative has osteoporosis or has broken a bone  My health is “fair” or “poor”  I smoke  I am underweight for my height  I started menopause before age 45  I’ve never gotten enough calcium  I have more than two drinks of alcohol several times a week  I have poor vision, even with glasses Activity – Risk Factor Worksheet

26. Are You at Risk for Weak Bones? Check Any of These that Apply to You  I sometimes fall  I’m not physically active  I have one of the these medical conditions: Hyperthyroidism Chronic lung disease Cancer Inflammatory bowel disease Chronic hepatic or renal disease Vitamin D deficiency Cushing’s disease Multiple sclerosis Rheumatoid arthritis Activity – Risk Factor Worksheet

27. Are You at Risk for Weak Bones? Check Any of These that Apply to You  I take one of these medications: Oral glucocorticoids (steroids) Cancer treatments (radiation, chemotherapy) Thyroid medicine Antiepileptic medications Gonadal hormone suppression Immunosuppressive agents Activity – Risk Factor Worksheet

28. Osteoporosis & Persons with Disabilities Low intake of dietary calcium Medications Weak or unused muscles Lack of accessibility to exercise facilities

29. Osteoporosis Affects Women & Men of All Ethnicities

30. RISK FACTOR REVIEW Discuss significant risks with a health care professional –Gender –Nutrition/Calcium Intake –Age –Medications –Family history –Recent falls or broken bones

31. STEPS TO PREVENTION

32. Live a Healthy Lifestyle Eat foods rich in calcium and vitamin D –Follow recommended daily amounts Be physically active every day –Include activities to improve strength and balance Maintain a healthy body weight

33. STEPS TO PREVENTION Don’t smoke Limit alcohol intake Limit caffeine

34. Skim Milk

38. BONE DENSITY TESTING

39. WHO SHOULD GET TESTED All women age 65 and older All postmenopausal women under 65 with 1 or more risk factors Men aged 70 and older Postmenopausal women who have had a fracture Women considering therapy for osteoporosis

40. Dual-Energy X-Ray Absorptiometry “Gold Standard” test to determine a diagnosis Measures hip & spine Painless, safe and requires no injections Takes 5-10 minutes Determines risk for fracture

41. UNDERSTANDING YOUR T-SCORE

42. TREATMENT OPTIONS

43. Medication For Prevention and/or Treatment In post-menopausal women 1. BISPHOSPHONATES a. Alendronate, Risedronate & Ibandronate Sodium 2. CALCITONIN 3. ESTROGEN THERAPY/HORMONE THERAPY 4. PARATHYROID HORMONE OR PTH (1-34) 5. SELECTIVE ESTROGEN RECEPTOR MODULATOR (SERM) a. Raloxifene

44. MEN More than 2 million men have the disease and nearly 12 million more are at risk Alendronate and PTH are approved for treatment of osteoporosis in men

45. FALL PREVENTION

46. Osteoporosis Falls Break Bones You can prevent most falls –Improve your balance, coordination, and strength through weight-bearing physical activity such as dancing or Tai Chi –Review medicines with a health care professional (some medicines may cause drowsiness or dizziness) –Have your vision checked –Make your home safer

47. PUTTING IT ALL TOGETHER You are never too old or too young to improve your bone health Adults –At least 30 minutes of moderate physical activity a day –Strength and balance training –Protect from falls –Eye exam to check for visual impairments –Bone density test with a fracture after age 50, and for everyone with risk factors –Bone density test for all women over age 65 –Extra calcium and vitamin D over age 50 –Medication, if indicated, to prevent bone loss or build new bone

48. Children & Teens –Teens are at greater risk for poor bone health because of rapidly growing bones and poor diet –At least one hour of physical activity a day –Increase calcium during teens Babies –Bone health begins before birth PUTTING IT ALL TOGETHER You are never too old or too young to improve your bone health

50. Let’s Work Together to Get Kentucky Bone Healthy!

51. Acknowledgements Thanks to: Florida Department of Health Osteoporosis Prevention & Education Program (Slides adapted with permission from Florida Department of Health Osteoporosis Prevention Curriculum for Adults)

52. Resources The 2004 Surgeon General’s Report on Bone Health and Osteoporosis: What It Means to You http://www.surgeongeneral.gov/library/bonehealth http://www.surgeongeneral.gov/library/bonehealth National Osteoporosis Foundation http://www.nof.orghttp://www.nof.org American Dental Association http://www.ada.org/public/media/releases/0210_release08.asp http://www.ada.org/public/media/releases/0210_release08.asp American Dietetic Association: http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/advocacy_1743_ENU_HTML.htm http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/advocacy_1743_ENU_HTML.htm Center for Disease Control and Prevention: http://www.cdc.gov/brfss; http://www.cdc.gov/nhanes http://www.cdc.gov/brfsshttp://www.cdc.gov/nhanes National Institute of Arthritis and Musculoskeletal and Skin Disease. Health Topics: Oral Health and Bone Disease. http://www.niams.nih.gov/bone/hi/oralhealth_bone.htm http://www.niams.nih.gov/bone/hi/oralhealth_bone.htm

54. Kentucky Department for Public Health Osteoporosis Prevention and Education Program 502-564-7996 ext. 3777