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Americans Over 50 at Risk for Bone Fractures

U.S. Surgeon General Richard H. Carmona, M.D., M.P.H., has warned that by 2020, half of all Americans older than 50 will be at risk for fractures from osteoporosis and low bone mass if no immediate action is taken by individuals at risk, doctors, health systems, and policymakers. The warning is published in an October 2004 report, Bone Health and Osteoporosis: A Report of the Surgeon General.

The report says that 10 million Americans over the age of 50 have osteoporosis, the most common bone disease, while another 34 million are at risk for developing osteoporosis. And each year, roughly 1.5 million people suffer a bone fracture related to osteoporosis.

This report is the first-ever Surgeon General's report on the topic of bone health. Osteoporosis and other bone diseases can lead to a downward spiral in physical health and quality of life, including losing the ability to walk, stand up, or dress. Bone disease can also lead to premature death.

Other findings in the report include:

• 1 in 5 older Americans who suffer a hip fracture die within a year of the fracture.
• 1 in 5 people with a hip fracture end up in a nursing home within a year.
• Hip fractures account for 300,000 hospitalizations annually.

"This report will shape the way we approach, talk, and act about bone diseases," says Health and Human Services Secretary Tommy G. Thompson. "The more we learn, the more we realize that so many diseases are preventable, from obesity, to many types of cancer, and now bone disease."

"Osteoporosis isn't just your grandmother's disease. We all need to take better care of our bones," says Carmona. "The good news is that you are never too old or too young to improve your bone health. With healthy nutrition, physical activity every day, and regular medical checkups and screenings, Americans of all ages can have strong bones and live longer, healthier lives. Likewise, if it's diagnosed in time, osteoporosis can be treated with new drugs that help prevent bone loss and rebuild bone before life-threatening fractures occur."

According to the report, osteoporosis is a "silent" condition because many Americans are unaware that their bone health is in jeopardy. In fact, the number of people who have osteoporosis is much greater than the number who report having the disease--four times as many men and nearly three times as many women. One of the most dangerous myths about osteoporosis is that only women need to worry about bone health. Osteoporosis affects men and women of all races, and while bone weakness is more common in older Americans, building strong bones begins in childhood.

The surgeon general's report is a call for Americans to take action to improve and maintain healthy bones. The report includes recommendations on what Americans can do to decrease the likelihood of developing osteoporosis, such as:

• Get the recommended amounts of calcium and vitamin D. High levels of calcium can be found in milk, leafy green vegetables, soybeans, yogurt, and cheese. Vitamin D is produced in the skin by exposure to the sun and is found in fortified milk and other foods. For people who are not getting enough calcium and vitamin D in the diet, supplements may be helpful.
• Maintain a healthy weight and be physically active at least 30 minutes a day for adults and 60 minutes daily for children. Include weight-bearing activities to improve strength and balance.
• Take steps to minimize the risk of falls by removing items that might cause tripping, improve lighting, and encourage regular vision tests and exercise to improve balance and coordination.

The report also calls on health care professionals to help Americans maintain healthy bones by evaluating risks for patients of all ages and recommending bone density tests for women over the age of 65 and for men and women over 50 who suffer even a minor fracture. Bone density tests use X-rays or sound waves to measure how strong the bones are. These tests are quick, safe, and painless.

Health care professionals should also look for "red flags" that may indicate that someone is at risk, including people who are under 50 who have had multiple fractures, or people who take medications or have a disease that can lead to bone loss.

The surgeon general has also published a companion "People's Piece" specifically written for the American public. The magazine-style, full-color booklet offers ready-to-use information on how people can improve their bone health.

The free People's Piece, The 2004 Surgeon General's Report on Bone Health and Osteoporosis: What It Means To You, is available by calling (866) 718-BONE (2663) or at www.surgeongeneral.gov.

Are You at Risk for Weak Bones?

If you have any of these "red flags," you could be at high risk for weak bones. Talk to your health care professional.

• 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
• I sometimes fall
• I'm not active
• I have one of these medical conditions:
  • hyperthyroidism
  • chronic lung disease
  • cancer
  • inflammatory bowel disease
  • chronic liver or kidney disease
  • hyperparathyroidism
  • vitamin D deficiency
  • Cushing's disease
  • multiple sclerosis
  • rheumatoid arthritis
• I take one of these medicines:
  • oral glucocorticoids (steroids)
  • cancer treatments (radiation, chemotherapy)
  • thyroid medicine
  • antiepileptic medications
  • gonadal hormone suppression
  • immunosuppressive agents

Your Body Needs Calcium

Source for Vitamin D chart and Calcium chart: The 2004 Surgeon General's Report on Bone Health and Osteoporosis: What it Means to You.

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