Osteoporosis Month – A Chance to Make a Difference

It’s Osteoporosis Month, which gives us a chance to focus on a debilitating and costly disease that effects a huge number of Americans. We probably all know someone, either a friend or a relative, who has osteoporosis, which is defined as porous bone. I remember, when I was much, much younger seeing old people who were bent over and had what appeared to be a big bump on their upper back. This is one of the symptoms of osteoporosis. My mother in-law suffered from this disease. Our bones are made up of living and growing tissue and are like honeycombs. If the spaces in the honeycomb become bigger over time, we develop osteoporosis and our bones become prone to breaking more easily. We can do things to strengthen our bones when we are younger but, since this is a blog for, and about, seniors, I want to concentrate on what we can do now to combat this disease.

Osteoporosis is often a silent disease; we many times don’t know we have it until we break a bone. It is more common in older women, but men are also at risk. White women and white men are more likely to get osteoporosis than their African American or Mexican American counterparts.

It’s important to assess whether we are at risk for osteoporosis. Take a moment and take the quiz below.

The more times you answer “yes,” the greater your risk of getting osteoporosis. Take this card with you to your next medical appointment and talk to your healthcare provider about what you can do to protect your bones.

During your visit with your doctor, remember to report:

• Any previous fractures.
• Your lifestyle habits, including diet, exercise, alcohol use, and smoking history.
• Current or past medical conditions and medications that could contribute to low bone mass and increased fracture risk.
• Your family history of osteoporosis and other diseases.
• For women, your menstrual history.

The doctor may also perform a physical exam that includes checking for:

• Loss of height and weight.
• Changes in posture.
• Balance and gait (the way you walk).
• Muscle strength, such as your ability to stand from sitting without using your arms.

In addition, your doctor may order a test that measures your bone mineral density (BMD) in a specific area of your bone, usually your spine and hip. BMD testing can be used to:

• Diagnose osteoporosis.
• Detect low bone density before osteoporosis develops.
• Help predict your risk of future fractures.
• Monitor the effectiveness of ongoing treatment for osteoporosis.

Thankfully, there are some things we can do right now to help us avoid the broken bones.

1. Get the calcium and vitamin D you need every day.
2. Do regular weight-bearing and muscle-strengthening exercises.
3. Don’t smoke or don’t drink too much alcohol.
4. Talk to your healthcare provider about your chance of getting osteoporosis and ask when you should have a bone density test.

A big part of limiting the impact osteoporosis has on our continuing health and mobility is seeking the necessary treatment after we break a bone or discover we have osteoporosis. Following our doctors’ recommendations to ensure we don’t have another broken bone is very important. Preventing a downward spiral that reduces our mobility and exacerbates other health problems we may have will go a long way toward maintaining our health.

How many times have you heard of an older person who fell and broke his/her hip and just continued to spiral down as that traumatic experience affected their overall health to the point they eventually died? It happened just that way with my mother-in-law. Broken bones put pressure on already fragile organs and can rob us of precious time with loved ones.

This disease has a huge financial effect on our nation. The Bone Health Policy Institute, which is part of The National Osteoporosis Foundation, did a report on the clinical and cost burden of fractures associated with osteoporosis. A great graphic that captures this information can be seen here. You can also see the financial impact in your state by clicking here.

As you know, I’m always looking for ways that we can work to make Medicare more efficient, especially through the use of preventative measures. The Foundation’s study had recommendations on ways we could improve Medicare to avoid the life limiting results of osteoporosis. Here are the report’s recommendations:

• Leading health systems like Geisinger and Kaiser Permanente have successfully reduced repeat fractures and lowered costs by employing a new model of coordinated care known as fracture liaison services (FLS). But most of those with fractures go without this cost-effective help because Medicare doesn’t incentivize its use.
  • Action – Congress and the Centers for Medicare and Medicaid Services (CMS) should make changes to Medicare payments to incentivize widespread use of model secondary fracture prevention/care coordination practices for beneficiaries who have suffered an osteoporosis-related fracture and are thus at risk for another fracture.
    
• Medicare pays for high-quality bone density testing to identify those who are at risk of bone fractures, allowing for early and effective preventive steps and interventions. However, the Milliman report found that only 9% of women who suffer a fracture are screened for osteoporosis within six months of a new fracture. Other analyses have shown that Medicare payment rates have been cut by 70% and in the last 5 years the osteoporosis diagnosis of older women has declined by 18%.
  • Action – These cuts to Medicare payment rates for osteoporosis screening, which have reduced access, should be reversed either administratively or by legislation.
    
• Medicare also pays for FDA-approved drug treatments for osteoporosis that can help reduce spine and hip fractures by up to 70% and cut subsequent fractures by about half. But about 80% go untreated, even after a fracture.
  • Action – Congress should mandate and fund a national education and action initiative aimed at reducing fractures among older Americans.

I can almost guarantee that you have osteoporosis or know someone who suffers from it. There are things we can do to reduce its impact on us, both in the steps we take in our own lives and things we can do to encourage those in Washington to improve Medicare’s approach toward preventative care for this debilitating disease. I encourage all of you to be active in improving your own health and by speaking out to those in Washington to let them know that, especially when it comes to osteoporosis, an ounce of prevention is absolutely worth a pound of cure.

Best, Thair