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Senior Citizen Health & Medicine
Older Men as Likely to Suffer Second Bone Break from
Osteoporosis as Women
Both sexes have 50% chance of second low-trauma
break with 10 years
 January 26, 2007 A new study, finding that older
men and women are very likely to follow a bone fracture with a second,
puts increased emphasis on the need for older men to be more aware of
osteoporosis and its potential to weaken bones to the breaking point.
Most studies of bone fractures in senior citizens have focused on older
women the most likely to develop this disease.
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For both sexes, absolute subsequent (low-trauma)
fracture risk was equal to or greater than the risk of an initial
fracture for a woman in a 10-year-older age bracket or for a man 20
years older, say authors of the article in the January 24 issue of the
Journal of the American Medical Association (JAMA).
In the study of people age 60 and over they found
that 50% of both men and women were likely to have a second low-trauma
fracture within 10 years of their first break.
The critical clinical relevance of these
findings, the article says, is that incident low-trauma fracture is a
signal for increased risk of all types of subsequent osteoporotic
fracture, particularly in the next 5 to 10 years.
They conclude
virtually all low-trauma fractures
indicate the clinical need for fracture preventive therapy, and given
the early peak of re-fracture, such preventive treatment should not be
delayed.
The lack of consideration of osteoporosis and
treatment initiatives by the medical profession and the public,
particularly in relation to men, should be the focus of education
initiatives, the researchers conclude.
(Read more about
osteoporosis below news story.)
Background
Despite substantial evidence that a prior fracture
results in an increased risk of subsequent fracture, less than 30
percent of postmenopausal women and less than 10 percent of men with
prior fracture are treated to help lower this risk.
Although some of this deficiency in treatment is
due to the overall lack of awareness of osteoporosis by the public and
primary caregivers, the relative importance of prior fracture in
relation to subsequent fracture risk does not appear to be fully
appreciated, particularly in men, according to background information in
the article.
There are few published long-term studies on
absolute risk of re-fracture in women, and fewer in men.
About the Study
Jacqueline R. Center, M.B.B.S., Ph.D., of the
Garvan Institute of Medical Research, St. Vincents Hospital, University
of New South Wales, Sydney, Australia, and colleagues examined absolute
re-fracture risks for a variety of osteoporotic fracture types in a
group of 1,760 men and 2,245 women age 60 years or older in Australia.
The participants were followed up for 16 years, from July 1989 through
April 2005.
There were 905 women and 337 men with an initial
fracture, of whom 253 women and 71 men experienced a subsequent
fracture.
Women had nearly twice the risk of re-fracture,
while men had 3.5 times the risk of re-fracture. The absolute risk of
subsequent fracture was similar in women and men. The increase in
absolute fracture risk remained for up to 10 years, by which time 40
percent to 60 percent of surviving women and men experienced a
subsequent fracture.
For women, the absolute re-fracture risk was
equivalent to or greater than the initial fracture risk of a woman 10
years older. For example, a 60- to 69-year-old woman with an initial
fracture had an absolute re-fracture risk comparable to or greater than
an initial fracture risk of a 70- to 79-year-old woman.
For men, the absolute risk of a subsequent fracture
was similar to that of women and equivalent to or greater than an
initial fracture risk of a woman 10 years older. For example, a 60- to
69-year-old mans absolute re-fracture risk was equivalent to or greater
than a 70- to 79-year-old womans initial fracture risk and similar to
the initial risk of a man at least 20 years older.
All fracture locations apart from rib (men) and
ankle (women) resulted in increased subsequent fracture risk, with
highest risks following hip and clinical vertebral fractures in younger
men. In further analyses, femoral neck bone mineral density, age, and
smoking were predictors of subsequent fracture in women and femoral neck
bone mineral density, physical activity, and calcium intake were
predictors in men.
Editor's Note: This work was partly funded by a
National Health & Medical Research Council (NH&MRC) grant (federal
granting body) and with unrestricted educational grants from Merck Sharp
and Dohme, Eli Lilly, and GE Lunar Corporation.
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About
Osteoporosis
By the
National Institute of Arthritis & Musculoskeletal & Skin
Diseases
Osteoporosis
is a disease in which the bones become weak and are more likely
to break. People with osteoporosis most often break bones in the
hip, spine, and wrist.
Who Gets
Osteoporosis?
In the
United States, 10 million people have osteoporosis. Millions
more have low bone mass (called osteopenia), placing them at
risk for osteoporosis and broken bones.
Osteoporosis
can strike at any age, but it is most common in older women.
Eighty percent of the people in the United States with
osteoporosis are women. One out of every two women and one in
four men over age 50 will break a bone in their lifetime due to
osteoporosis.
What Causes
Osteoporosis?
Many risk
factors can lead to bone loss and osteoporosis. Some of these
things you cannot change and others you can.
Risk factors
you cannot change include:
Gender.
Women get osteoporosis more often than men.
● Age. The older you are, the greater your risk of
osteoporosis.
● Body size. Small, thin women are at greater risk.
● Ethnicity. White and Asian women are at highest risk. Black
and Hispanic women have a lower risk.
● Family history. Osteoporosis tends to run in families. If a
family member has osteoporosis or breaks a bone, there is a
greater chance that you will too.
Other risk
factors are:
● Sex
hormones. Low estrogen levels due to missing menstrual periods
or to menopause can cause osteoporosis in women. Low
testosterone levels can bring on osteoporosis in men.
● Anorexia nervosa. This eating disorder can lead to
osteoporosis.
● Calcium and vitamin D intake. A diet low in calcium and
vitamin D makes you more prone to bone loss.
● Medication use. Some medicines increase the risk of
osteoporosis.
● Activity level. Lack of exercise or long-term bed rest can
cause weak bones.
● Smoking. Cigarettes are bad for bones, heart, and lungs.
● Drinking alcohol. Too much alcohol can cause bone loss and
broken bones.
Can
Osteoporosis Be Prevented?
There are
many steps you can take to keep your bones healthy. To keep your
bones strong and slow down bone loss, you can:
● Eat a
diet rich in calcium and vitamin D
● Exercise
● Not drink in excess or smoke.
Nutrition
A diet with
enough calcium and vitamin D helps make your bones strong. Many
people get less than half the calcium they need. Good sources of
calcium are:
Low-fat
milk, yogurt, and cheese
Foods with
added calcium such as orange juice, cereals, and breads
Vitamin D is
needed for strong bones. Your body makes vitamin D in the skin
when you are out in the sun. Some people get all the vitamin D
they need from sunlight. Others need to take vitamin D pills.
The chart on this page shows the amount of calcium and vitamin D
you should get each day.
>> More from
National Institute of Arthritis & Musculoskeletal & Skin
Diseases |
>>
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