Osteoporosis is the most common bone disease in humans and affects both men and women. The clinical and public health implications of the disease are substantial because of the mortality, morbidity, and cost of medical care associated with osteoporotic fractures. Osteoporosis is diagnosed on the basis of a low-impact or fragility fracture or low bone mineral density, which was best assessed by central dual-energy x-ray absorptiometry. Both nonpharmacological therapy (calcium and vitamin D supplementation, weight-bearing exercise, and fall prevention) and pharmacological treatments (antiresorptive and anabolic agents) may be helpful in the prevention and treatment of osteoporosis. Therefore, clinicians need to be vigilant in instituting primary prevention measures for those at high risk for osteoporosis and in instituting treatment for patients diagnosed as having the disease either by screening or a history of fracture. This article provides an overview of the diagnosis, screening, prevention, and treatment of osteoporosis.
BMD (bone mineral density), DXA (dual-energy x-ray absorptiometry), FDA (Food and Drug Administration), ICSI (Institute for Clinical Systems Improvement), NOF (National Osteoporosis Foundation)Osteoporosis Diagnosis Essay
Osteoporosis is the most common bone disease in humans and affects both men and women, usually during or beyond the seventh decade of life. Among US women older than 50 years, 13% to18% meet current diagnostic criteria for osteoporosis, and an additional 37% to 50% meet criteria for osteopenia. For men of the same age, 3% to 6% meet criteria for osteoporosis, and 28% to 47% meet criteria for osteopenia.1 Osteoporosis has clinical and public health implications because of the mortality, morbidity, and cost of medical care associated with osteoporotic fractures. Elderly persons constitute the fastest-growing age group in the world, and the annual number of osteoporotic fractures is predicted to increase considerably with the continued aging of this population in future decades. In the United States, about 1.5 million fractures are attributed to osteoporosis each year. Of this total, approximately half are vertebral fractures and one fifth each are hip, wrist, and other fractures,2 Although therapy that can reduce the risk of osteoporotic fractures is available, osteoporosis often remains undiagnosed until a fracture occurs. In addition, patients with osteoporosis-related fractures often are not evaluated or treated for osteoporosis and sustain additional fractures. Therefore, clinicians need to be vigilant in instituting primary prevention measures for those at high risk for osteoporosis and in instituting treatment for patients diagnosed with the disease either by screening or a history of fracture. This article provides an overview of the diagnosis, screening, prevention, and treatment of osteoporosis.Osteoporosis Diagnosis Essay
DEFINITION
Osteoporosis is a chronic, progressive disease characterized by low bone mass, microarchitectural bone deterioration, and decreased bone strength that lead to increased bone fragility and a consequent increase in fracture risk.3 Osteoporosis may be classified as either primary or secondary. Primary osteoporosis is bone loss associated with the aging process in both women and men and with the loss of gonadal function in men. In primary osteoporosis, the rate of activation of skeletal bone remodeling units is normal, but the filling of bone resorption pits is incomplete. Secondary osteoporosis is bone loss caused by a variety of chronic medical conditions, medications, and nutritional deficiencies. In most types of secondary osteoporosis, the rate of activation of skeletal bone remodeling units is increased at least initially, such that an increased proportion of the skeleton is undergoing remodeling at any one time. Some common secondary causes of osteoporosis and disease processes associated with the disorder Osteoporosis Diagnosis Essay
Before 1994, the diagnosis of osteoporosis required evidence of a fragility fracture. In 1994, the World Health Organization established operational definitions of osteoporosis and osteopenia in postmenopausal white women based on bone mineral density (BMD) (Table 2) to help researchers and clinicians classify degrees of bone loss. Expert opinion, based on literature review, suggests that the current World Health Organization definition of osteoporosis in postmenopausal white women can be applied to men as well.5 In current clinical practice, osteoporosis is diagnosed on the basis of either a health outcome (low-impact or fragility fracture) or an intermediate outcome (low BMD). A low-impact fracture is one that occurs after a fall from standing height or less; a fragility fracture occurs spontaneously or with no trauma (cough, sneeze, sudden movement).
TABLE 2World Health Orga