With more than 44 million Americans , over the age of 50, afflicted, osteoporosis has become a health epidemic of enormous proportions. Leading to nearly $17 billion dollars in health care costs, the risk factors, prevention and treatment of this “silent thief” will significantly impact a woman’s self image. Through it’s progression, osteoporosis restricts movement, decreases mobility, results in loss of height and creates severe back pain. Osteoporosis, by definition, is a skeletal disease resulting in “porous bone” meaning bone mass and integrity are compromised. When this occurs, stooped posture progresses which can lead to compression on the lungs and stomach. The condition results in nearly 1.5 million bone fractures, including hop fractures, per year and nearly 24% of all hip fracture patients die within one year of their injury. Due to these statistics, women have become increasingly concerned with the risk factors, prevention and treatment of osteoporosis.
In terms of risk factors, it has been found that osteoporosis does not discriminate based on age or gender. Studies do, however, support post-menopausal, Caucasian women, who smoke, are low in calcium intake, consume alcohol and take psychotropic medications, may be at the highest risk for development of the disease. Women who develop early menopause, due to late childbirth, stress, environmental toxins or cancer treatments, are also at risk. Although studies have shown the benefits of hormone replacement therapy, through the introduction of estrogen into the body, aide in slowing the progression of osteoporosis. In fact, evidence supports the risk for osteoporosis is immediately evident as soon as hormone replacement therapy is discontinued. Because of the hormonal shifts, and the progression of osteoporosis, women vary in their mental perception of the diagnosis from acceptance to denial to surrender. Additionally, women diagnosed with anorexia nervosa, an eating disorder, also suffer significantly higher risks in terms of developing osteoporosis. This higher risk may be due to inactivity which further lowers bone mineral density developed and the health status of the nervosa patient.
As risk factors are identified, so are the methods of prevention. At present, there is very little disease awareness among early adult women. For both men and woment, it is believed the peak period of bone density development occurs between the ages of 25 and 35 years. Because of this, education in prevention has become increasingly important. As a primary preventative measure, funding for school awareness has been proposed to educate and empower young adult women in areas of self esteem, body image, nutrition, eating disorders, alcohol, smoking and exercise. The push for physical fitness is a key preventative measure as it provides the young adult woman with the greatest and the least expensive form of prevention. Fitness will improve balance, improve muscle strength and agility. Primary prevention programs also includes awareness in terms of increasing calcium and Vitamin D intake, monitoring weight changes and obtaining early bone density testing. To facilitate this prevention message, middle and high schools, in addition to college campuses, are targeting this age group.
In addition to the primary preventative method of education, health care workers are targeting a secondary group for preventation; women diagnosed and in early stages of the disease. With this prevention program, women are provided counseling in an effort to aide the patient in overcoming feelings of depression, anxiety, insomnia and a fear of falling. Counseling programs will also incorporate a family planning and counseling program to increase family awareness and develop a support program. The goal of the program is to increase awareness, decrease disease progression and begin the patient on medications, testing and weight bearing exercise programs.
For women in the final, progressed stages of osteoporosis, there is increasing concern with levels of mortality. As pain increases and self image decreases, women begin to withdraw from activities, become more isolated, discontinue household chores and begin to experience inconsistent sleep patterns. It has been recommended that social workers begin a more aggressive approach to reach these patients in an effort to improve mortality rates. Support groups such as “Building Strength Together” have been developed to offer assistance to those patients in need. Additionally, Medicare has approved bone density testing and treatment for adults over 65 and many older adults are utilizing emergency neck devices and home delivery meals to ensure nutritional standards are maintained.
Risk factors, prevention, awareness and treatment over the course of a woman’s entire life span may help to decrease the number of Americans diagnosed and suffering from osteoporosis. Although financial costs are enormous, the greater cost and impact of osteoporosis is seen in the patient’s suffering, deformity and disability. Researchers have recommended that all women begin bone density testing at an early age and that society begin an aggressive awareness campaign to women of all ages. In addition, researchers have suggested that testing and research begin to address the needs of our male counterparts, in an effort to wipe out the “silent thief” known as osteoporosis.