Prevent Osteoporosis: Steps to Healthy Bones in Kentucky

1. GET “BONE” HEALTHY KENTUCKY Prevent Osteoporosis…

2. SPONSORED BY: Kentucky Department for Public Health Osteoporosis Prevention and Education Program

3. PRESENTED BY:

5. What Is Osteoporosis ? • What Happens When Bones Break ? • How Common Is It ? • What Are The Risk Factors ? • Steps To Prevention • Bone Density Testing • Treatment Options • Fall Prevention • Summary

6. WHAT IS OSTEOPOROSIS ? • Osteo = bone • Porosis = full of holes • Osteoporosis = means bones that are full of holes

7. Normal Bone

8. Osteoporosis

9. NORMAL HEALTHY BONE OSTEOCLASTS OSTEOBLASTS

10. OSTEOPOROTIC BONE The loss of living bone tissue makes bones fragile and more likely to fracture.

12. Women: Role of Estrogen • Hormone that protects against bone loss • After menopause, estrogen production decreases – may lead to rapid bone loss • Rate of Bone Loss in Postmenopausal Women • 1% to 2% annual loss for 10 years after menopause • Fastest in first 3 to 6 years

13. WHAT HAPPENS WHEN BONES BREAK

14. OsteoporosisWhen Bones Break • The most common breaks in weak bones are in the: • Wrist • Spine • Hip • If you break a bone after the age of 50, talk to your health care professional about measuring your bone density

15. Normal Osteoporotic Spine Fracture Compressed bone Fractured

17. OsteoporosisWhen Bones Break • Hip fractures are the most devastating • One in five elderly people die within a year of the fracture • One in five must move to a nursing home within a year • One in four become disabled • Many become isolated and depressed

18. Did you Know? • Someone with osteoporosis may have weakened jawbones and be prone to losing teeth • Recent studies show women with osteoporosis have been reported to have 3 times more tooth loss than women without the disease.

19. HOW COMMON IS OSTEOPOROSIS?

22. KENTUCKY STATISTICS (2002) • Women • 128,000 osteoporosis • 342,000 low bone mass Projections for 2010 834,000 Kentuckians age 50 & over will be affected. Men 37,300 osteoporosis 223,400 low bone mass National Osteoporosis Foundation

23. RISK FACTORS

24. Are You at Risk for Weak Bones?Check Any of These that Apply to You • I’m older than 65 • I’ve broken a bone after age 50 • My close relative has osteoporosis or has broken a bone • My health is “fair” or “poor” • I smoke • I am underweight for my height • I started menopause before age 45 • I’ve never gotten enough calcium • I have more than two drinks of alcohol several times a week • I have poor vision, even with glasses Activity – Risk Factor Worksheet

25. Are You at Risk for Weak Bones?Check Any of These that Apply to You • I sometimes fall • I’m not physically active • I have one of the these medical conditions: Hyperthyroidism Chronic lung disease Cancer Inflammatory bowel disease Chronic hepatic or renal disease Vitamin D deficiency Cushing’s disease Multiple sclerosis Rheumatoid arthritis Activity – Risk Factor Worksheet

26. Are You at Risk for Weak Bones?Check Any of These that Apply to You • I take one of these medications: Oral glucocorticoids (steroids) Cancer treatments (radiation, chemotherapy) Thyroid medicine Antiepileptic medications Gonadal hormone suppression Immunosuppressive agents Activity – Risk Factor Worksheet

27. Osteoporosis & Persons with Disabilities • Low intake of dietary calcium • Medications • Weak or unused muscles • Lack of accessibility to exercise facilities

28. Osteoporosis Affects Women & Men of All Ethnicities

29. RISK FACTOR REVIEW • Discuss significant risks with a health care professional • Gender • Nutrition/Calcium Intake • Age • Medications • Family history • Recent falls or broken bones

30. STEPS TO PREVENTION

31. STEPS TO PREVENTION Live a Healthy Lifestyle • Eat foods rich in calcium and vitamin D • Follow recommended daily amounts • Be physically active every day • Include activities to improve strength and balance • Maintain a healthy body weight

32. STEPS TO PREVENTION • Don’t smoke • Limit alcohol intake • Limit caffeine

33. Skim Milk

37. BONE DENSITY TESTING

38. WHO SHOULD GET TESTED • All women age 65 and older • All postmenopausal women under 65 with 1 or more risk factors • Men aged 70 and older • Postmenopausal women who have had a fracture • Women considering therapy for osteoporosis

39. Dual-Energy X-RayAbsorptiometry • “Gold Standard” test to determine a diagnosis • Measures hip & spine • Painless, safe and requires no injections • Takes 5-10 minutes • Determines risk for fracture

40. UNDERSTANDING YOUR T-SCORE

41. TREATMENT OPTIONS

42. Medication For Prevention and/or Treatment • In post-menopausal women • 1. BISPHOSPHONATES • a. Alendronate, Risedronate & Ibandronate Sodium • 2. CALCITONIN3. ESTROGEN THERAPY/HORMONE THERAPY • 4. PARATHYROID HORMONE OR PTH (1-34)5. SELECTIVE ESTROGEN RECEPTOR MODULATOR (SERM) • a. Raloxifene

43. MEN • More than 2 million men have the disease and nearly 12 million more are at risk • Alendronate and PTH are approved for treatment of osteoporosis in men

44. FALL PREVENTION

45. OsteoporosisFalls Break Bones • You can prevent most falls • Improve your balance, coordination, and strength through weight-bearing physical activity such as dancing or Tai Chi • Review medicines with a health care professional (some medicines may cause drowsiness or dizziness) • Have your vision checked • Make your home safer

46. Adults At least 30 minutes of moderate physical activity a day Strength and balance training Protect from falls Eye exam to check for visual impairments Bone density test with a fracture after age 50, and for everyone with risk factors Bone density test for all women over age 65 Extra calcium and vitamin D over age 50 Medication, if indicated, to prevent bone loss or build new bone PUTTING IT ALL TOGETHER You are never too old or too young to improve your bone health

47. PUTTING IT ALL TOGETHERYou are never too old or too young to improve your bone health • Children & Teens • Teens are at greater risk for poor bone health because of rapidly growing bones and poor diet • At least one hour of physical activity a day • Increase calcium during teens • Babies • Bone health begins before birth

49. Let’s Work Together to Get KentuckyBone Healthy!

50. Acknowledgements Thanks to: Florida Department of Health Osteoporosis Prevention & Education Program (Slides adapted with permission from Florida Department of Health Osteoporosis Prevention Curriculum for Adults)