The Joplin Globe, Joplin, MO

Senior Outlook

Discussion

March 3, 2010

Dr. Debra Buckler: Best osteoporosis treatment is prevention

When it comes to hip fractures, prevention is the best cure

Older people often worry about breaking bones, particularly their hips. The estimated lifetime risk of developing a hip fracture is 17 percent for women and six percent for men. It’s a common problem among senior citizens in this country.

The chance of fracturing a hip goes up with age. A simple fall from the standing position is the type of fall that causes hip fractures 90 percent of the time. Often, people report that the hip hurts or gives way prior to the actual fall, leading many to believe that hips actually fracture spontaneously in a large number of cases. Osteoporosis plays a major role in hip fractures as well. Because osteoporosis is found mainly in women, women have nearly a three times better chance of experiencing a hip fracture than do men.

Hip fractures generally require surgical repair. In addition to the surgical risks involved, patients with hip fractures face an increased risk of blood clots and infection. Also, because of decreased mobility during the recovery period, patients might possibly develop pneumonia and bedsores. Overall, the one-year mortality rate following a hip fracture is as high as 24 percent. And 50 percent of people with hip fracture do not regain their ability to live independently.

What can you do to decrease your risk of hip fracture? First, get screened for osteoporosis. Most people begin these screenings in their 50s or 60s. While especially recommended for women, osteoporosis screenings can benefit men too, particularly those with a family history of osteoporosis in male family members.

Recommendations to decrease the risk of osteoporosis also call for people to follow a healthy diet, starting at a young age if possible, that includes calcium from milk and milk products. An adult over age 50 needs around 1,200 mg of calcium daily to maintain bone health. People also need adequate amounts of vitamin D, and experts recommend that those over 50 take 800-1,000 IU of vitamin D3 daily as well. Also, osteoporosis risk increases with caffeine intake and smoking, so avoid these.

Exercise can reduce your risk of falls and your risk of osteoporosis. Healthy bones result from activity, so you should follow a regular exercise routine. The improved balance and muscle tone you experience from exercise makes falls less likely. Weight bearing exercises such as walking are the best for strengthening bones.

Another way to reduce your risk of breaking your hip is to reduce the risk of falling by removing clutter from the home environment. This is especially important for someone who is frail and uses a walking aid. A throw rug might look nice, but could easily become a fall hazard. Also, it is important to maintain adequate lighting in the evenings and at night to make falling less likely.

If you have problems with balance, a walker or cane could save your life. Discuss these assistive devices with your healthcare provider — I recommend involving a physical therapist to help select and fit a device tailored to your needs. Your health care provider can arrange a physical therapy referral.

If you happen to suffer a hip fracture, it is important to have proper help during your recovery. This recovery period is physician-directed and often involves a stay in a rehabilitation center or nursing home. Physical and occupational therapy teams will guide your exercise and encourage you through your recovery. While it is tempting to try to go home as soon as possible after a hip fracture, a course of therapy will often improve your ultimate outcome and is usually covered by most medical insurance plans.

Hip fractures are common and can lead to devastating results. The best treatment is to avoid the fracture in the first place by maintaining good health with a proper diet and exercise program. Take care of yourself — I wish you good health as you age.

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Senior Outlook