Thursday, December 12, 2013

Risk Factors for Osteoporosis and Hip Fractures


When it comes to osteoporosis, there are certain risk factors which people can avoid, and then there are those which are unavoidable. So obviously you want to make changes in the ones where you can make a difference.

Osteoporosis can predispose an individual to fractures in the wrist, hip, and the spine. These injuries can affect a person's ability to walk and may increase mortality. For instance, it is well known that the one-year mortality rate after a patient sustains a hip fracture is over 25%.

The biggest risk factor that people can't avoid is older age. As a person ages, they simply do not have as high of a bone turnover rate as they did while younger. What this means is that more bone is lost than is made each year, which leads to a gradual reduction in bone mineral density. If this amounts to 1 to 2% per year, think about over a 20 year period that person will have 20 to 40% less dense bone.

Additional risk factors that one cannot change is being female and a family history of osteoporosis. There are genetic factors to osteoporosis, a lot of which we do not understand. Being female and having a higher incidence of osteoporosis than men has to do with hormone levels and what happens after menopause.

Additional risk factors that cannot be modified include rheumatoid arthritis along with disorders such as hyperthyroidism and having a testosterone deficiency. Also, simply having a previous osteoporosis fracture can predispose individuals to developing future ones.

Now let's talk about the risk factors that people can modify. Weight-bearing exercise is one of the best ways to reduce your risk of developing fractures from osteoporosis. This does not include cycling or swimming, as those do not involve weight bearing. This involves such activities as walking, running, weightlifting, and those types of activities. In and of itself, weight-bearing exercise is the number 1 method of preventing osteoporosis.

Additional risk factors that can be modified include smoking and poor nutrition. If a patient has poor nutritional habits, they're not going to be be getting enough vitamins or calcium to ensure superior bone health. Smoking can decrease the blood supply to the bone and cause them to become brittle. The absolute worst combination is a patient who is thin, female, older, and white. This combination predisposes to osteoporosis tremendously.

Excessive alcohol intake is another risk factor for the problem. Alcohol directly interferes with the body's ability to produce bone. So along with the other problems that alcoholics develop, osteoporosis can easily be one of them.

Additional risk factors for developing osteoporosis include various medications. These are modifiable, but at times a patient has to take them because nothing else better is available for their disease. For instance, glucocorticoids like cortisone are often times necessary for a patient with rheumatoid arthritis.

Patients who take anticonvulsants are predisposed to osteoporosis along with methotrexate and the medication called cyclosporine. All of these can cause osteoporosis either by themselves or in conjunction with the additional risk factors.

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