Osteoporosis is the most common bone disease, affecting millions of Americans over the age of 50 every year.
Although more commonly diagnosed in postmenopausal women, osteoporosis can also affect men. Osteoporosis is characterized by low bone mass and fragility that results in decreased bone strength. This can lead to an increase in bone fractures.
“There are no symptoms for osteoporosis and unfortunately the first sign is an actual fracture or bone break that occurs after a fall,” said physician assistant Jayme Clark, Interim Fairfield Region Medical Director for Hartford HealthCare Medical Group. “We typically encourage patients to start thinking about osteoporosis after age 50 when we will assess risk factors for fractures.”
Through a DEXA scan, which stands for Dual-Energy X-ray Absorptiometry, your doctor can assess your bone metabolism, or how the body regulates calcium and other minerals by constantly breaking bone down at a cellular level and building it up. This is normal, but with osteoporosis it happens too much which leads to bone loss. For women who have risk factors, screening is advised for all women older than 65 and in postmenopausal women with risk factors younger than 65.
Risk factors include:
- Advanced age.
- Previous bone fractures.
- Long-term use of steroids.
- Low body weight.
- Excess alcohol use.
- Race/ethnicity (African American women tend to have a slightly higher rate of osteoporosis).
“It’s a very easy exam where you lie on a special X-ray table and an X-ray arm will pass over your body to assess your bones,” Clark said. “You will likely have to change into a gown but it is very comfortable and non-invasive. The results will go to a radiologist to interpret and then to your doctor to communicate the results with you.”
All DEXA scans are given a T-Score, which is a statistical number that compares your risk of fracture based on your bone mineral composition against the risk of fracture in a young, healthy adult. A T-Score that is equal to or less than minus-2.5 indicates osteoporosis, while a score between minus-1.0 and minus-2.5 means osteopenia — a precursor to osteoporosis. Anything higher than minus-1.0 is normal.
If your T-Score is consistent with osteoporosis, treatment can include:
- Vitamin D and calcium supplements.
- Quitting smoking.
“Studies have shown that exercise reduces the occurrence of fractures in older adults and that smoking can accelerate bone loss,” Clark said. “All women go through menopause, which is a risk factor in itself, but leading a healthy lifestyle through exercise, ensuring you have enough calcium and vitamin D in your diet, not smoking and drinking, can all help avoid osteoporosis.”