by P. Payne

Created on: May 04, 2009   Last Updated: May 11, 2009

The human body is in a continual state of change, continually renewing itself while we are young, but slowing down its processes as we age. As we grow older, our ability to recover from some maladies or broken bones lessens, especially if osteoporosis is involved.

Throughout our lives, there is a process of bone loss and growth. But as we age, the process slows down and more loss occurs than growth. The result can be osteoporosis, which puts a great part of the current U.S. population at risk.

Without sufficient amounts of calcium, the body cannot maintain strong bones. Ideally, children would maintain a healthy diet with an adequate intake of calcium, Vitamin D, and other minerals, and get enough exercise to avoid osteoporosis later in life. Unfortunately for many, that has not been the case.

According to the International Osteoporosis Foundation, osteoporosis means "porous bone." Over time, bone density is reduced, increasing risk for fractures. Osteoporosis often is not diagnosed until a person breaks a bone for the first time. Both men and women are at increased risk for fractures as they age. Wrist, hip, and spine fractures are the most common. Spine fractures can result in loss of height, back pain, and deformities. Hip fractures may require surgery.

The National Osteoporosis Foundation indicates more than 25 million Americans are affected by osteoporosis, resulting in about 1.2 bone fractures every year. The numbers can only become larger with the aging United States population. Risk factors include age and family history, but a host of other factors also can influence chances of contracting the disease. Those most at risk include post-menopausal women, people with a history of eating disorders, women and men with a slender build, and those who smoke or abuse alcohol. An inadequate intake of calcium and a sedentary lifestyle contribute to osteoporosis risk. Genetic factors come into play, but nutrition, exercise and other lifestyle factors influence the rate of bone loss and how well bone is replaced as we age. Several medications, including diuretics, steroids, and anticonvulsants, also can affect bone and have an impact on its loss.

Osteoporosis can be treated and many fractures can be avoided. Dual energy X-ray absorptiometry, called DXA, is used to measure bone mass density. Currently, it is the only reliable diagnostic test for osteoporosis, according to the Mayo Clinic. The test measures how many grams of calcium and other bone minerals are packed into a segment of bone.

Test results can be used to plan treatment and changes to lifestyle to prevent fractures. After an osteoporosis diagnosis, drug treatments may be prescribed to maintain bone density and reduce fracture risk. Hormone replacement therapy also may be used for its benefits to bone. Calcium and Vitamin D supplements usually are prescribed with drug therapy to ensure the patient gets enough calcium. Vitamin D and protein also are important in prevention and maintaining bone density.

There also are small DXA scanners called peripheral DXA machines, but they do not yet have a uniform reference standard that can apply to all machines and all manufacturers, and are not as reliable.

Another method, called QCT (Quantitative computed tomography) can be used to assess bone mass density using a standard CT scanner. It is not in general clinical use because it costs more and there is greater radiation exposure.

Ultrasound is a fairly new way to measure BMD. The results are not as precise, but the procedure can be done in the doctor's office. Once its accuracy is improved, ultrasound may become more commonly used to for screening.

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