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Osteoporosis: Preventing the Hump

Posted June 13, 2013 by Vivian E. von Gruenigen, M.D.

As women in my family age, we get "the hump." Have you seen older ladies with an abnormal outward curve of the upper back with round shoulders and stooped posture? It's called a Dowager's hump or kyphosis. It is directly related to osteoporosis or thin, brittle bones. My grandmother, mother and aunt all developed this disease despite medication later in life. Genetic factors contribute to osteoporosis by influencing bone mineral density. The goal for me and my siblings is earlier prevention.

Approximately, 10-15% of U.S. women aged 50 years and older have osteoporosis and another 40% have low bone mass or osteopenia. Both have an increased risk of fracture, including the hip and spine. Therefore, the hump is caused by significant bone loss resulting in anterior compression of the vertebrae.

Risk factors include family history (me!), menopause, smoking, poor nutrition, estrogen deficiency, long-term low calcium intake, inadequate physical activity, and a history of falls. Medical conditions such as diabetes, stroke, multiple sclerosis and others are associated with an increased risk of osteoporosis. Even certain medications like steroids, cytotoxic chemotherapeutics, and anticonvulsants may increase the risk.

Prevention is the key; however, screening strategies and medications are available. All women aged 65 years and older should be tested for bone mineral density. Women should consume between 1,000-1,500 mg/d of calcium using supplements if dietary sources are not adequate. Women should have adequate vitamin D (400-800 international units/d) and exposure to the natural sources of this nutrient. Regular weight-bearing and muscle-strengthening exercise, smoking cessation, and moderation of alcohol are also important.

Advances in knowledge about the genetic basis of osteoporosis will improve the understanding of this disease. Researchers are exploring new genetic markers to assess fracture risk and in identifying genes and proteins that form molecular targets for the design of the next generation of drug treatments.

Start preventing osteoporosis now. Pay attention to your lifestyle and ask your healthcare professional about being screened.


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