post-menopausally in women and in men in their later middle years. And that’s why, in case you’ve ever wondered about it, all fractures including those of the hip and wrist are so much more common in the elderly than in the young, even though young kids engage in much riskier physical activities than their grandparents do.
. .. So bone mass is much like your savings: the more money you put away when you’re still earning some, the more you can withstand life’s inevitable costs when the money stops coming in. With bones, if you don’t build your greatest possible bone mass when you’re young, there’s not as much bone to draw on later in life when you start drawing down your deposits of bone.
. .. What this all means, then, is that all of us have less bone mass at age 80 than we had at age 18, but only some of us have bones thin enough to be diagnosed with osteoporosis.
. .. There are certain well-known risk factors that raise the risk of OP. These start with a genetic susceptibility, of course, so if you’ve got a strong family history of OP, there’s a good chance you’ll get it yourself, especially if you don’t do all you can to lower your risk. As well, OP occurs at far higher rates among Caucasians and people of Asian extraction.
Other major risk factors for OP include a history of smoking, excessive alcohol intake, a poor diet (especially a lack of calcium and vitamin D), diseases that interfere with the absorption of calcium and/or vitamin D, a sedentary lifestyle, and the use of certain drugs, most notoriously steroids.
. .. Why does OP matter so much? Because, as I wrote earlier, it causes tremendous disability, not to mention that it kills, too. Thus, 20-25 % of people who break a hip die within 6 months, and of those who survive a hip fracture, it’s said that about 25 % will never regain their pre-fracture mobility.
. .. And that’s just the consequences of hip fractures. OP fractures also occur frequently in the wrist (in Montreal, where I trained, any icy day used to result in dozens of older folks coming in to the ER with a wrist fracture from putting their hands out to break a fall) as well as fractures of the vertebrae, and fractures in both those sites often result in significant chronic pain for the rest of that person’s life.
. .. How do you treat OP? The good news is that there are lots of choices. The bad news is that whenever there are lots of choices, it means that none are terrific |
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