10 Facts About Osteoporosis
This silent disease significantly raises your risk for fractures and disability.
1. Losing bone density is a normal part of aging. We reach peak bone mass between ages 25 and 30, and then slowly lose begin to start losing bone mass at age 40. For women, reduced levels of estrogen after menopause accelerate bone density loss.
“Women lose 1.5 to 2 percent of their bone density per year in the first 10 years after menopause,” says Laura Ryan, MD, clinical associate professor of medicine in the division of endocrinology, diabetes, and metabolism at The Ohio State University Wexner Medical Center in Columbus.
2. You don’t lose bone mass randomly. Bone resembles scaffolding, with vertical and horizontal structures that make the bone strong without a lot of bulk, explains Dr. Ryan. When you lose bone density, you lose the horizontal structures — not the vertical ones — which reduces your bone strength.
3. Gender, ethnicity, and body size can raise your risk for osteoporosis. While there are certain things you can do to help reduce your risk of osteoporosis, like quitting smoking and getting enough calcium and vitamin D, there are also some uncontrollable risk factors.
According to the NOF, some of those risk factors include: being a female, being over age 50, having low body weight, or having a family history of osteoporosis. Caucasian and Asian women are at the highest risk of developing osteoporosis because of differences in bone mass and bone structure compared with other ethnic groups.
4. Men get osteoporosis later than women. Men have a 10-year head start over women in terms of their bone health, says Stephen Honig, MD, director of the Osteoporosis Center at NYU Langone Health in New York City. That’s because men have greater bone density going into middle age and their rate of bone density loss is generally more gradual. If men do develop osteoporosis, it’s typically later in life than women do. “However, once men develop osteoporosis, they are more likely than women to experience a fracture. So all men over the age of 75 should have a bone density screening,” adds Ryan.
5. Osteoporosis increases your risk of fractures. People with osteoporosis are more likely than people without the condition to break a bone, says Dr. Honig.
According to the NOF, one out of two women will eventually break a bone due to osteoporosis — most likely in the hip, spine, or wrist. These fractures can be serious: 60 percent of people who suffer hip fractures are unable to walk again without assistance one year later. And 20 percent of hip fracture patients over age 50 die within a year due to related complications.
The most common osteoporosis-related fracture occurs in the spine, and is known as a vertebral compression fracture. Multiple fractures like these can result in a loss of height as well as the telltale osteoporosis humpback, called a dowager’s hump.
6. Osteoporosis screening is recommended for older adults. The NOF recommends that women without other risk factors have their first bone density screening at age 65.
Women who’ve already had a fracture or who have other risk factors, such as rheumatoid arthritis, a history of smoking or heavy drinking, low body weight, or long-term use of corticosteroids should talk to their doctor about having a bone density screening earlier. The test is an X-ray of the hip and spine using a central dual energy X-ray absorptiometry (DXA) machine.
7. The most important goal when you have osteoporosis is to prevent fractures. The best way to prevent yourself from breaking a bone is to take steps to help prevent falls. Start with these strategies:
- Use assistive devices, such as a cane or walker, if you’re unstable on your feet.
- Prevent slips by wearing rubber-soled shoes.
- Use runners on slippery floors.
- Put non-skid pads under your rugs.
- Install grab bars in the bathroom.
- Use handrails on stairs.
- Upgrade or add lighting in your home so you don’t trip and fall in the dark.
- Stay as strong as you can by exercising and doing weight bearing exercises that are appropriate for you.
8. Calcium and vitamin D are key for bone health. Adult men and women need 1,000 to 1,200 milligrams (mg) of calcium daily for healthy bones. It’s best to get your calcium from food sources, such as low-fat dairy, leafy green vegetables, canned sardines, salmon, and foods with added calcium.
If you have trouble getting enough calcium from your diet, you may need calcium supplements. Your body can only absorb about 500 mg of calcium at a time, Ryan says, so it can help to take smaller doses of calcium supplements two or three times a day instead of one larger dose. Be sure to follow your doctor’s recommendation.
You also need vitamin D to help your body absorb calcium. The recommended daily intake of vitamin D for healthy adults is up to 1,000 mg, though you may need more in the winter if you live in a place where there’s not a lot of sunlight — or if you’re at risk for low bone density, says Ryan. Again, your doctor can measure your vitamin D level and prescribe a supplement regimen if necessary.
9. Osteoporosis treatments include medications and physical therapy.There are two types of osteoporosis medications: antiresorptive medication, which slow bone loss; and anabolic medication, which increase the rate of bone formation.
It’s important to work with your doctor to devise a treatment plan that works best for you, depending on your health history and individual circumstances.
On top of your prescribed treatment plan, your doctor may also recommend physical therapy, which can teach you how to strengthen your core muscles and improve your body mechanics to help prevent falls.
10. Leading a healthy lifestyle helps keep your bones strong. Getting regular exercise, especially with weight-bearing activities, helps strengthen muscles and improve balance and posture, making you less likely to fall. It’s also important to limit alcohol consumption and avoid smoking cigarettes or using other tobacco products.
In addition, take steps to avoid risky physical behaviors that may lead to falls and fractures, and maintain a healthy body weight. “It’s good to have a little cushion around your bones,” Honig says.
Is Bone Mass Measurement Covered?
How often is it covered?
Medicare Part B (Medical Insurance) covers this test once every 24 months for people who meet the criteria below. This test may be covered more often if it’s medically necessary. This test helps to see if you’re at risk for broken bones.
All qualified people with Part B who are at risk for osteoporosis and meet one or more of these conditions:
- A woman whose doctor determines both of these (based on her medical history and other findings):
- She’s estrogen deficient
- She’s at risk for osteoporosis
- A person whose X-rays show possible osteoporosis, osteopenia, or vertebral fractures
- A person taking prednisone or steroid-type drugs or is planning to begin this treatment
- A person who has been diagnosed with primary hyperparathyroidism
- A person who is being monitored to see if their osteoporosis drug therapy is working
Your costs in Original Medicare
You pay nothing for this test if the doctor or other qualified health care provider accepts assignment.
Note: Your doctor or other health care provider may recommend you get services more often than Medicare covers. Or, they may recommend services that Medicare doesn’t cover. If this happens, you may have to pay some or all of the costs. Ask questions so you understand why your doctor is recommending certain services and whether Medicare will pay for them.