A national survey of 1,000 women ages 30 and older conducted by
Prevention magazine found that women and their doctors are sorely
misinformed about osteoporosis. And many women aren't taking even
the most basic steps to reduce their risks. Here are some of the
shocking findings:
+ Seven out of 10 women say that their doctors have never talked
to them about osteoporosis -- even though one out of two women will
break a bone because of osteoporosis sometime after the age of 50.
+ More than half of the women who break a bone after turning 50
-- which is a symptom of osteoporosis -- say that their doctors have
never recommended that they be tested for this disease by getting a
bone-density test.
+ Less than one-quarter of the women who have a family history
of osteoporosis -- one of the top risk factors -- say that their
doctors have recommended that they get a bone-density test.
+ Only 11 percent of the women surveyed think that it's very
likely that they will get osteoporosis, even though one in five
women can expect to develop the disease in her lifetime. Among
women over 50 who probably already have this disease -- evidenced by
breaking a bone -- only 17 percent think that it's very likely that
they will become victims.
Not only is this bone-thinning disease deadly (complications
from hip fracture kill about 35,000 people a year), it's a major
crippler of women. It can rob you of your independence: your
ability to walk, play with your grandchildren, cook for yourself,
plant flowers in the spring, even climb into the tub for a relaxing
bubble bath.
The most serious complication of osteoporosis is hip fracture.
Only one-third of all people who fracture their hip ever fully
recover.
It often means a prolonged stay in a nursing home. But for as
many as one in five, it may mean death within one year.
Even a moderate case of osteoporosis -- characterized by stooped
posture, chronic back pain and height loss -- can make everyday
movements, such as hooking your bra or enjoying a walk, a luxury of
the past.
It doesn't take a hip fracture to change the quality of your
life either.
``Many women fear changes in their appearance as they age,''
says Dr. John Bilezikian, director of the Metabolic Bone Diseases
Program at Columbia-Presbyterian Medical Center in New York City.
``But if they were aware of the changes to their appearance with
osteoporosis, they might take this disease more seriously.''
The loss of height that you experience with osteoporosis is
caused when the vertebrae in your spine become so thin that they
begin to collapse under the weight of your own body. There isn't
enough room for your internal organs, so they push out, creating a
bulging stomach.
``Your clothes won't fit anymore,'' Bilezikian says. ``They'll
hang unevenly if you develop curvature of the spine due to the
collapsing vertebrae.''
Considering that it's such a devastating disease, why are women
so misinformed about osteoporosis? Many experts believe that it's
because their doctors are misinformed too. Until recently, there
was little doctors could do. Diagnostic tools have only been widely
available in the past five years, which means that most treatments
are relatively new.
``Doctors are only beginning to learn how to deal with
osteoporosis in the same way that they now deal with heart
disease,'' explains Dr. Robert Lindsay, immediate past president of
the National Osteoporosis Foundation. ``You don't see bone loss.
Since it doesn't cause any problems until a fracture occurs, in
many ways it's similar to where we were with heart disease 10 years
ago, when we didn't recognize people with it until they had a heart
attack. Now we understand the role of cholesterol in creating
plaque buildup in coronary arteries.''
Lindsay estimates that ``the average primary care physician sees
about 10 or 11 patients every week who have osteoporosis. But
doctors are so busy dealing with the problem that the patient came
to see them for, that they don't look for or recognize the unseen
bone loss.''
Also, those physicians who went to medical school 10 or more
years ago simply didn't learn much about osteoporosis. Thus, it's
off their radar.
While it might be understandable that primary care physicians
miss signs of osteoporosis, you would expect orthopedic surgeons,
who treat broken bones, to be more alert to bone disease. Not so,
Bilezikian says. ``A patient with any kind of bone fracture should
alert the orthopedist to the need for an evaluation for
osteoporosis. Yet, we get relatively few referrals a year from our
orthopedic surgeons here at Columbia-Presbyterian Medical Center.''
The NOF regards physician education as a top priority, Lindsay
says. ``it's a matter of getting physicians to the point where, for
example, recommending a bone-density test for a 55-year-old woman
whose mother just broke her hip becomes automatic.''
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SIDEBAR: DO YOU KNOW THE RISK FACTORS?
In a survey of 1,000 women conducted by Prevention magazine, 70
percent knew that a diet low in calcium put them at risk for
developing osteoporosis, and 53 percent knew that not exercising
enough increased their risk as well.
But only 38 percent of women 50 and older knew that menopause
itself increases the risk -- perhaps by as much as 50 percent -- due
to the loss of estrogen. Here is a list of the major risk factors:
+ A personal history of bone fracture as an adult
+ History of fractures in a first-degree relative (mother,
grandmother, sister)
+ Current cigarette smoking
+ A slender build (less than 127 pounds for an average-size
woman)
+ Use of steroid medications
+ Estrogen deficiency due to early menopause or the removal of
ovaries
+ Any loss of menstrual periods for six months or more (with the
exception of pregnancy)
+ Heavy alcohol consumption
+ Lack of physical activity
