/images/pg/osteo_educ.gif"> Osteoporosis, or porous bone, is a disease characterized by low bone mass and structural deterioration of bone tissue leading to bone fragility and an increased susceptibility to fractures of the hip, spine and wrist. What Causes It? As you age, you lose a greater amount of old bone than your body can replace with new bone tissue; some medications such as corticosteroids may induce this loss. Who Is At Risk? Women are at greater risk than men because they start with less bone mass. They also lose bone mass more rapidly after menopause. Certain people are more likely to develop osteoporosis than others. Factors that increase the likelihood of developing osteoporosis are called "risk factors." The following risk factors have been identified: • Being female • Thin and/or small frame • Advanced age • A family history of osteoporosis • Postmenopause, including early or surgically induced menopause • Abnormal absence of menstrual periods (amenorrhea) • Anorexia nervosa • A diet low in calcium • Use of certain medications, such as corticosteroids and anticonvulsants • Low testosterone levels in men • An inactive lifestyle • Cigarette smoking • Excessive use of alcohol • Being Caucasian or Asian, although African Americans and Hispanic Americans are at significant risk as well Women can lose up to 20% of their bone mass in the five to seven years following menopause, making them more susceptible to osteoporosis. /images/rheum/osteo_02.jpg" align="right">Osteoporosis is a major public health threat for more than 44 million Americans, 68 percent of whom are women. In the U.S. today, 10 million individuals already have the disease and almost 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis. • Eight million American women and 2 million men have osteoporosis, and an estimated 34 million have low bone density. • Significant risk has been reported in people of all ethnic backgrounds. • While osteoporosis is often thought of as an older person's disease, it can strike at any age. Symptoms Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a fracture or a vertebra to collapse. Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as kyphosis (stooped posture). Prevention By about age 20, the average woman has acquired 98% of her skeletal mass. Building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later. There are four steps to prevent osteoporosis. No one step alone is enough to prevent osteoporosis, but all four may. /images/rheum/osteo_05.gif" align="right"> They are: • A balanced diet rich in calcium and vitamin D • Weight-bearing exercise • A healthy lifestyle with no smoking or excessive alcohol intake, and • Bone density testing and medication when appropriate How Is It Diagnosed? Specialized tests called bone density tests can measure bone density in various sites of the body. A bone density test can: • Detect osteoporosis before a fracture occurs • Predict your chances of fracturing in the future • Determine your rate of bone loss and/or monitor the effects of treatment if the test is conducted at intervals of a year or more Treatment Options • Medications: Alendronate; Bisphosphonates -- such as alendronate, etidronate, clodronate, Fosamax, pamidronate, tilvdronate; Calcitonin nasal spray • Calcium supplements • Estrogen • Exercise • Sodium fluoride Resources National Osteoporosis Foundation 1232 22nd Street N.W. Washington, D.C. 20037-1292 (202) 223-2226 http://www.nof.org/ Information compiled from the Arthritis Foundation & the National Osteoporosis Foundation