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Osteoporosis (week 8).docx

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Health Studies
HLTH 230
Jeffery Lalonde

Osteoporosis  Metabolic bone disease characterized by low bone mass  Deterioration of bone tissue  Results in increase in fragility fractures o Hip o Spine o Wrist  Bigger spaces in bones  1 in 4 women over the age of 50 has osteoporosis  1 in men over 50 has osteoporosis o Can strike at any age  Symptoms o Pain o Reduced height o Marked curvature of the spine  Kyphosis  Hunched over  Compresses GI tract, abdomen  Breathing issues  Major Risk Factors o Over the age of 65 o Vertebral compression fracture o Fragility fracture after age 40 o Family history of osteoporotic fracture o Malabsorption syndrome  Celiac or Crohns disease o Tendency to fall o Osteopenia  Precursor o Receiving glucocortticoid thereapy  Asthma o Hyperparathyroidism o Early menopause  Minor Risk Factors o Arthritis o Hyperthyroidism o Low calcium intake o Smoker o Excessive alcohol intake o Excessive cafferine intake o Weight under 125 lbs or 57 kg o Weight loss o Herapin therapy o Anticonvulsant therapy  Factors That Can Be Modified o Low bone mineral density o Low body weight o High alcohol use o Smoking o Excess caffeine o Low calcium intake o Low vitamin D exposure o Sedentary lifestyle  Non Modifiable Risk Factors o Previous fracture o History of fragility fractures o Poor health o Advanced age o Female sex o White / asian race o Secondary causes  disease Prevalence  Pediatric disease with geriatric consequences o Affects later generations o Our generation pays  Need prevention and intervention  Peak bone mass is reached in adolescents o Manifests itself later  Need better nutritional choices  Lifestyle habits  Common in white Asian women over 50 o Black ethnicities better utilize calcium  Fractures from osteoporosis are more common than heart attack, stroke, and breast cancer combined o 1 in 3 women  Over 50 o 1 in 5 men  Over 65  Will experience osteoporotic fracture during lifetime  Risk of fracture is higher following a previous vertebral fracture  Increased risk of death  Costs o Diagnosis o Monitoring o Treatment o Fractures  Fragility fractures  Human costs o Reduced quality of life o Disfigurement o Lowered self esteem o Reduction or loss of mobility o Decreased independence Bone Mineral Density  The weight of mineral per volume of bone o 1. Liquid bone barrow o 2. Half mineral, half protein  Strength of bone o How many mineral atoms are within bone matrix o How porous (spongy) the matrix is T score  Normal bone o Better than -1  Osteopenia o Precursor to osteoporosis  Between -1 to -2.5  Osteoporosis o Greater than -2.5  Z score o Number of standard deviations below average according to age Quality of Bone  May have quantity, but not quantity  Used in assessing fracture risk o Using bone mineral density and fracture risks to assess patients Bone Remodeling  Bone is living tissue o Constantly renewing itself o Subject to wear and tear  Remodeling process completed every 3 – 4 months  Osteoclasts o Excavate (remove) any areas of crumbling or weakened bone  Osteoblasts BLAST IT IN o Fill the creviced with material that calcifies to form new bone Age Related Factors  Insufficient bone remodeling  Reduced calcium intake o Impaired calcium absorption  Poor vitamin D status o Decreased exposure, decreased ability of kidneys to activate  Hormonal changes o Parathyroid, calcitonin, estrogen Effects of Aging  Systems become less efficient  Osteoclasts remove old bone faster than osteoblasts can rebuild it  Calcium absorbed less effectively o Regular calcium intake helps remodeling process stay balanced  Lowers bone loss  Lower risk of fracture Calcium and Childhood  Calcium is necessary to grow a healthy skeleton to support a growing body  Age 20 in men and age 16 in women o Bone stops growing in length o Almost at peak bone mass  Density of bones depends on calcium intake as kids and teenagers  Children who are active have increase in bone growth o Age 30 peak bone mass  More mass you have at peak, less likely to have fracture Bone Mass Loss  After 35, men and women begin to lose bone mass at about 1% a year o Women lose more after menopause  Over 45% over her lifetime o Men lose after age 65  Only lose 2/3 of what women lose Maintaining Bone Mass  Maintain bone mass as we age  Physical activity combined with adequate calcium and vitamin D Fragility Fracture  Fracture that results from minimal trauma such as a fall from standing height or less  Importance of Height Loss o Increased risk of vertebral fracture  Symptoms  Back pain, sleep disturbance, reduced quality of life  Signs  Height loss  Kyphosis  Protruding abdomen  Reduced lung function  Weight loss  Loss of function  Impaired activites, dressing, di
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