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US Pharm. 2012;37(10):8.
The surgeon general’s report states that, by 2020, half of all
Americans aged ≥50 years will have weak bones unless they change their
diet and lifestyle. Thirty years ago, health care professionals believed
that weak bones and fractures were facts of aging and that little could
be done, but today’s physicians know how to improve bone health and can
detect and treat bone diseases.
Children: Strong bones begin in childhood. Calcium and
vitamin D intake and weight-bearing physical activity help determine
bone mass. Activities such as running, dancing, climbing stairs, and
weightlifting can boost bone development, and the best weight-bearing
activities are team sports. Lack of physical activity results in loss of
bone mass, especially during long periods of immobilization or
inactivity. In the years of peak skeletal growth (ages 8-19 years),
youngsters accumulate more than 25% of adult bone. By the time teenagers
finish their growth spurt (about age 17 years), 90% of their adult bone
mass is formed, and the bones continue to increase in density until
about age 30 years.
Osteoporosis: Approximately 40 million people have
osteoporosis or are at high risk because of low bone mass. Osteoporosis
develops when bone resorption occurs too quickly or when replacement
occurs too slowly after peak bone mass is reached. Osteoporosis is more
likely to develop if a person did not reach optimal peak bone mass
during the bone-building years. In women, bone loss is fastest (20%) the
first few years after menopause and continues into the postmenopausal
years.
Bone Mineral Density (BMD): Irrespective of age and
race, females have lower BMD than males, according to the 2005 National
Health and Nutrition Examination Survey. Among non-Hispanic black
subjects aged ≥50, 20–49, and 8–19 years, females had 15.4%, 9.7%, and
6.4% lower BMD, respectively, than males. Mexican American women aged
≥50 years had the least difference in BMD versus men. As males’ age
progressed from 8–19 to 20–49 years, BMD increased by 15%, versus 12% in
females. With progression to ≥50 years, however, BMD dropped more in
women (12%) than in men (6.1%).
Fractures: Each year, 1.5 million older people suffer
fractures because their bones have weakened. An elderly person who
breaks a hip is four times more likely to die within 3 months or
experience a downward spiral in health. One in 5 hip fracture patients
ends up in a nursing home within 1 year; others may become isolated or
depressed or restrict their mobility because of fear of falling. The
expense of treating broken bones from osteoporosis is $18 billion
annually.
To comment on this article, contact rdavidson@uspharmacist.com.
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