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Post-Polio Health (ISSN 1066-5331)

Vol. 16, No. 1, Winter 2000

More about Osteoporosis

Osteoporosis is a debilitating disease in which bones become fragile and are more likely to break. In most cases, it can be prevented and treated but if steps are not taken, it progresses painlessly until a bone breaks.

Osteoporosis affects more than 28 million Americans, 80% of whom are women. In the United States today, 10 million already have osteoporosis and 18 million more have low bone mass placing them at increased risk for developing it.

People need to know whether they are at risk for developing osteoporosis or whether they already have lost so much bone that they already have osteoporosis. While risk factors* can alert a person to the possibility of low bone density, only a bone mineral density (BMD) test can measure current bone density, diagnose osteoporosis and determine fracture risk. There are many different techniques that measure BMD painlessly and safely. The majority of these machines use extremely low levels of radiation while ultrasound machines use sound waves instead.

Medicare and many private insurance carriers cover bone density tests to detect osteoporosis for individuals who meet certain criteria. Talk with your doctor about whether or not this test would be appropriate for you.

Depending on the results of the test, you and your physician may decide that you should begin a Food and Drug Administration (FDA) approved medication for osteoporosis to stop bone loss, improve bone density and reduce fracture risk.

Several medications have been developed to help manage osteoporosis and to strengthen bones in women at high risk for the disease. Hormone replacement therapy (HRT - estrogen and progesterone) helps to prevent osteoporosis by slowing bone loss. However, HRT carries certain risks, most notably an increased risk of breast cancer, and may not be the best choice for some women.

Other medications are available to prevent and manage osteoporosis without the risks associated with HRT. Alendronate, a drug known as a bisphosphonate, slows bone loss and increases bone density. Another medicine, calcitonin, has been shown to improve bone density and lessen back pain due to osteoporosis. Raloxifene, developed to help prevent osteoporosis, belongs to a class of drugs called SERMs, or "selective estrogen receptor modulators." Raloxifene has been shown to build bone without increasing the risks of breast or uterine cancer.

You can do your part to protect bone health by following osteoporosis prevention and treatment strategies.


Prevention of Falls and Fractures

Safety First to Prevent Falls

At any age, people can improve their environments in ways that reduce their risk of falling and breaking a bone.

Outdoor Safety Tips
Indoor Safety Tips

Source: National Osteoporosis Foundation, 1232 22nd Street NW, Washington, DC 20037 (202-223-2226, www.nof.org).


Memory and Aging

Not all changes in memory are due to disease, but some that accompany normal aging may be amenable to forms of treatment that are also under study as possible Alzheimer therapies. One involves the hormone estrogen, thought to protect against a variety of conditions including osteoporosis and cardiovascular disease, but doctors are cautious about its use because it may increase the risk of breast cancer.

In recent years, studies have suggested that estrogen protects memory. In 1998, an observational study of more than 700 healthy post-menopausal women, led by researchers from Columbia University College of Physicians and Surgeons, found that those who used estrogen replacement therapy scored significantly higher than non-users on memory tests, and also on tests of language and abstract reasoning. Moreover, the estrogen-users' performance on a test of verbal memory improved slightly during an average 30 months of follow-up, as they continued on estrogen replacement therapy. These preliminary results suggest the time may be ripe for clinical trials of estrogen as a memory strengthener during healthy aging (Jacobs et al, 1998).

SOURCE: The Dana Alliance for Brain Initiatives' "Delivering Results: A Progress Report on Brain Research, Update 1999: New Connections."