1. Osteoporosis

2. Bone Basics Bones are complex, living tissues that: Bones are complex, living tissues that: Provide structural support for muscles, Provide structural support for muscles, Protect vital organs Protect vital organs Store the calcium essential for bone density and strength Store the calcium essential for bone density and strength Bones are built and stored until the age of 30. Bones are built and stored until the age of 30. During the aging process, bones break down faster than new ones are formed. During the aging process, bones break down faster than new ones are formed.

3. Osteoporosis: What is it? Disease in which bones become fragile and more likely to break. Disease in which bones become fragile and more likely to break. Broken bones, or fractures, typically occur in hip, spine, and wrist. Broken bones, or fractures, typically occur in hip, spine, and wrist.

4. Osteoporosis Facts 10 million Americans have osteoporosis; 34 million at risk. 1 10 million Americans have osteoporosis; 34 million at risk. 1 8 million are women; 2 million are men. 1 8 million are women; 2 million are men. 1 Significant risk for all ethnic backgrounds. 1 Significant risk for all ethnic backgrounds. 1 Can strike at any age. 1 Can strike at any age. 1 Responsible for more than 1.5 million fractures annually. 1 Responsible for more than 1.5 million fractures annually. 1 1. “Osteoporosis Fast Facts.” National Osteoporosis Foundation. February 17, 2005. http://www.nof.org.

5. Symptoms “Silent disease” “Silent disease” Collapsed vertebrae may be initially seen or felt in the form of: Collapsed vertebrae may be initially seen or felt in the form of: Severe back pain Severe back pain Loss of height Loss of height Spinal deformities such as kyphosis or stooped posture Spinal deformities such as kyphosis or stooped posture

6. Risk Factors Personal history of fracture after age 50 Personal history of fracture after age 50 Current low bone mass Current low bone mass Female Female Thin and/or having a small frame (under 127 lbs.) Thin and/or having a small frame (under 127 lbs.) Advanced age Advanced age Estrogen deficiency as a result of menopause, especially early or surgically induced Estrogen deficiency as a result of menopause, especially early or surgically induced Abnormal absence of menstrual periods Abnormal absence of menstrual periods Anorexia nervosa Anorexia nervosa

7. Risk Factors (cont.) Low lifetime calcium intake Low lifetime calcium intake Vitamin D deficiency Vitamin D deficiency Use of certain medications Use of certain medications Presence of certain chronic medical conditions Presence of certain chronic medical conditions Low testosterone levels in men Low testosterone levels in men Inactive lifestyle Inactive lifestyle Current cigarette smoking Current cigarette smoking Excessive use of alcohol Excessive use of alcohol

8. Detection Bone density tests can: Bone density tests can: Detect osteoporosis before a fracture occurs Detect osteoporosis before a fracture occurs Predict future chances of fractures Predict future chances of fractures Determine your rate of bone loss and/or monitor the effects of treatment Determine your rate of bone loss and/or monitor the effects of treatment Bone density is compared to two standards: Bone density is compared to two standards: Age matched Age matched Young normal Young normal

9. Prevention Steps to optimize bone health and prevent osteoporosis: Steps to optimize bone health and prevent osteoporosis: Keep a balanced diet rich in calcium and vitamin D Keep a balanced diet rich in calcium and vitamin D Exercise regularly (weight-bearing) Exercise regularly (weight-bearing) Maintain a healthy lifestyle (no smoking or excessive alcohol intake) Maintain a healthy lifestyle (no smoking or excessive alcohol intake) Bone density testing and medication when appropriate Bone density testing and medication when appropriate

10. Recommended Calcium Intakes 1 Ages Amount mg/day Birth- 6 months 210 6 months- 1 year 270 1-3500 4-8800 9-131300 14-181300 19-301000 31-501000 51-701200 70 or older 1200 Pregnant & Lactating 1000 14-181300 19-501000 1. Source: National Academy of Sciences (NAS).

11. Ways to Increase Calcium Intake Diet of calcium-rich food: Diet of calcium-rich food: Low-fat milk Low-fat milk Cheese Cheese Broccoli Broccoli Yogurt Yogurt Calcium-added foods (breakfast bars, orange juice, cereals) Calcium-added foods (breakfast bars, orange juice, cereals) Add nonfat powdered dry milk to puddings, breads, soups, etc. Add nonfat powdered dry milk to puddings, breads, soups, etc. Supplements Supplements Available in pills, capsules, chewable tablets, chewable candies, powders and tablets. Available in pills, capsules, chewable tablets, chewable candies, powders and tablets.

12. Suggestions for Choosing Supplements Determine your daily calcium intake from food. Determine your daily calcium intake from food. Decide which form of calcium will be the easiest for you to take. Decide which form of calcium will be the easiest for you to take. Calcium absorbs better in small doses and with food. Calcium absorbs better in small doses and with food. Vitamin D is essential for calcium absorption. Vitamin D is essential for calcium absorption.

13. Medications No cure for osteoporosis No cure for osteoporosis Following medications approved to prevent/or treat osteoporosis: Following medications approved to prevent/or treat osteoporosis: Bisphosphonates Bisphosphonates Calcitonin Calcitonin Estrogen/Hormone Therapy Estrogen/Hormone Therapy Parathyroid Hormone Parathyroid Hormone Selective Estrogen Receptor Modulators Selective Estrogen Receptor Modulators

14. Fall Prevention Especially important for osteoporosis sufferers. Especially important for osteoporosis sufferers. Falls can be caused by: Falls can be caused by: Medications such as sedatives, muscles relaxants and blood pressure drugs. Medications such as sedatives, muscles relaxants and blood pressure drugs. Combinations of two or more drugs. Combinations of two or more drugs. Diminished vision, hearing, muscle strength, coordination and reflexes. Diminished vision, hearing, muscle strength, coordination and reflexes.

15. Safety Checklist Floors: Floors: Remove all loose wires, cords, and throw rugs. Remove all loose wires, cords, and throw rugs. Keep furniture in its accustomed place. Keep furniture in its accustomed place. Bathrooms: Bathrooms: Install grab bars and non-skid tape. Install grab bars and non-skid tape. Lighting: Lighting: Make sure halls, stairways and entrances are well-lit. Make sure halls, stairways and entrances are well-lit. Install night lights Install night lights

16. Safety Checklist cont. Kitchen: Kitchen: Install non-skid mats near sink and stove. Install non-skid mats near sink and stove. Clean spills immediately. Clean spills immediately. Stairs: Stairs: Make sure treads, rails and rugs are secure. Make sure treads, rails and rugs are secure. Other precautions: Other precautions: Wear sturdy, rubber-soled shoes. Wear sturdy, rubber-soled shoes. Limit alcohol intake. Limit alcohol intake. Ask doctor if medications might cause falls. Ask doctor if medications might cause falls.

17. Questions? Thank You!