1. Osteoporosis
Osteoporosis is defined as a loss of bone mass or bone mineral density characterized by height reduction, fractures, back/neck pain, and stooped postures.
Osteoporosis affects mostly the bone of the spine, hip, lumber, and femur.

2. Osteoporosis
Osteoporosis affects both men and women, but with a higher incidence in women over fifty to sixty five years of age and higher or after menopause.
Osteoporosis affects about nine percent of women aged sixty five and older, compared with four point three percent of men.
The prevalence did not increase much in men until eighty years and above according to center for disease control report.

3. Risk factors for Osteoporosis
Age; fifty to sixty five years in women or after menopause and eighty years old and over in men
Sex; osteoporosis affect more women than men.
Race/ethnicity; affects more Caucasian and Hispanic than African American decent.
Small stature; People of little stature tends to have more predisposition to osteoporosis.

4. Risk factors for Osteoporosis
Nutrition; lack of adequate dietary calcium/mineral intake can put anyone at high risk for osteoporosis.
Lack of muscle strengthening exercise like walking
Medication; Immunosuppressive medications like steroids can put anyone at high risk for osteoporosis.
Smoking can lead to vasomotor constriction, reducing blood supply to the bone and eventually calcium/mineral reduction as well.

5. Identification of Health Condition
With an increasingly aging population, osteoporosis has become a major public health concern.
According to USPSTF 2011, approximately 12 million Americans aged 50 years and older are expected to be diagnosed
At least one half of all post-menopausal women will have an osteoporosis-related fracture during their lifetime.
Overall osteoporosis and associated disease will cost the US health care delivery system an estimated $17 billion and an annual projected cost of $50 billion by year 2040

6. Pathophysiology of Osteoporosis
Osteoporosis is a systemic skeletal disorder that occurs from an imbalance in bone remodeling, leading to a reduction in bone strength and fragility
This occurs either through failure to achieve peak bone mass and/or excessive bone resorption (osteoclast) or formation (osteoblast) during remodeling
Peak bone mass is achieved by ages years old, afterward bone loss begins
Menopause and post menopause accelerates this process due to decreased in estrogen and an increased in bone resorption, resulting in osteoporosis.

7. Management of Osteoporosis
Osteoporosis management involves both pharmacologic and non-pharmacologic measures such as lifestyle modification, nutritional recommendations and drug therapy.
Patients at risk or who have diagnosis of osteoporosis should be encouraged to make some life style changes to avoid bone loss.
Weight bearing exercise at least three times a week is good for the health of the skeleton and will help in the prevention of fracture.
The intake of adequate amount of low fat milk, weight loss and exercise help to reduce the incidence of osteoporosis.

8. Pharmcological Management
The incidence of osteoporosis increases with age, most elderly patients will require pharmacologic therapy to effectively reduce their fracture risk.
The pharmacological treatment includes bisphosphonate such as alendronate, risedronate, ibandronate, and zoledronic acid.
Other biphosphonate medications are denosumab, raloxifene, calcitonin and teriparatide.
Bisphosphates belong to class of antiresorptive whose function is to slow bone remodeling and increase bone density.
Alendronate and risedronate decrease the risk of vertebral, hip and wrist fractures by 0-50% over 2-4 years, ibandronate decreases vertebral fractures by as much as 50% over 3 years

9. Implications for Health Care
Osteoporosis is a common condition and the economic burden of osteoporosis-related fractures is significant
The costs of caring for hip fractures are not limited to this initial treatment it also requires follow-up care as a direct result of their injury.
According to the National Osteoporosis Foundation (NOF), the annual incidence of fragility fractures is more than the combined total incidence of heart attacks, strokes, and newly diagnosed breast cancer cases each year.
In 2004 according to the Healthcare Effectiveness Data and Information Set (HEDIS) used by National Committee for Quality Assurance (NCQA), revealed that only 18 percent of osteoporotic patients received osteoporosis management after a fracture.

10. Implications for Health Care
Future efforts emphasized education of general practitioners and patients about the importance of fracture and fracture prevention.
Tussing and Chapman-Novakofski (2009) showed that educational programs on osteoporosis prevention increased the likelihood of calcium consumption in their subjects.
A study conducted in 2009 by Kulp, Rane, and Bachmann showed that the use of the educational video on osteoporosis improved patient knowledge and positively impacted their health-related behaviors.
Hence, revealing that proper preventive education has a positive impact on modifiable behaviors leading to decreased osteoporosis and osteoporosis related injury.

11. Prevention of Osteoporosis
Prevention of osteoporosis is tailored towards reduction of modifiable risk factors such as
Regular muscle strengthening exercise.
Intake of adequate recommended dietary supplement of Calcium, Vitamin D, and minerals.
Regular bone density screening test for women over fifty.
Educating patient on early signs of osteoporosis like pain in the spine, back, hip, and lumber areas.

12. Prevention of Osteoporosis
Educating the patient on steroids to be aware of their risk.
Educate the patient on good nutrition including the consumption milk, and milk product that are rich in calcium and vitamin D with minerals.
Early diagnosis by provider is also very paramount for immediate treatment.

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