Bone health an important goal
Each February we shine a light on cardiovascular health in honor of American Heart Month, which includes National Wear Red Day, to raise awareness of heart disease. November is Pancreatic Cancer Awareness Month, which serves to raise awareness and funding for research. These monthly observances are wonderful— they fuel important health conversations and drive people to take action to help defeat these diseases. However, when May came and went with little to no coverage of National Osteoporosis Month, I was disappointed to say the least, especially when I witnessed more media coverage surrounding “National Pizza Month” — October, in case you were wondering. In fact, most people likely stepped right into June, blissfully unaware of National Osteoporosis Month; more significantly, probably dangerously unaware of the risk and serious consequences of fractures, i.e. broken bones, due to osteoporosis, a disease that causes no symptoms until a fracture occurs. It is time for all of us – doctors included – to take bone health more seriously.
I recently led a study published in the medical journal, Osteoporosis International, to analyze hip fracture trends in the U.S. with Medicare claims data from 2002 to 2015 for women 65 and older. What we found was alarming. In contrast to the historical trend of decreasing annual incidence of hip fractures between 2002 and 2012, rates plateaued at levels higher than projected in 2013, 2014 and 2015. This corresponds to more than 11,000 hip fractures beyond what was projected. At an average cost of $40,000 per hip fracture, it has added nearly $460 million in potentially avoidable costs to our healthcare system. More important than the costs are the consequences in terms of pain, disability, death and what is most feared by many of us — loss of independence. If a patient is fortunate enough to survive a hip fracture, it may not be possible to return to the former level of function, and some will be permanently confined to a nursing home.
There are many factors that contribute to this disturbing trend. Among them are a decline in bone density tests performed by dual-energy X-ray absorptiometry (DXA) and a decrease in numbers of high-risk patients being treated. The National Osteoporosis Foundation (NOF) recommends DXA testing for all women age 65 years and older and all men 70 and older, yet this often does not happen. Worse yet, most patients with osteoporotic fractures, including hip fractures, are not evaluated and treated to reduce the risk of another fracture. As a society, we can do better. As the population ages, it is more important than ever to focus on disorders like osteoporosis that can be prevented and treated. According to the International Society for Clinical Densitometry, each year osteoporosis causes more than two million broken bones in the U.S. alone, and the U.S. Surgeon General has identified it as a major public health concern. This number can and should be reduced. If you qualify for a bone density test according to your age, or if you are over 50 and have already suffered a broken bone, ask your health care provider about having a DXA test, the only test that can diagnose osteoporosis before a broken bone occurs. Early detection and treatment of osteoporosis may improve your quality of life and even save it.
Bone health should be part of everyday health dialogue, not only during National Osteoporosis Month, but throughout the year. The NOF and the Osteoporosis Foundation of New Mexico can provide you with helpful information about osteoporosis. Talk to your health care provider about your bone health and the risk of breaking a bone. The conversation is likely way overdue.