Osteoporosis and Fracture Risk Factors
 

Low bone density as measured by dexascan is one of many risk factors associated with bone fracture. There are two major issues with bone health--the structural strength of bone that cannot be measured and bone mineralization as measured by dexascan. We can lower fracture risk by increasing the structural strength of our bones even if our bone mineral density does not improve. You might find it interesting to see how various researchers look at fracture risk and low bone mineral risk. I'm including a few examples.

Most Common Risk Factors For Both Fracture And Osteoporosis:

1. personal history of fracture with low trauma
2. mother had bone fracture before age 80
3. poor general health

Risk Factors For Osteoporosis or Low Bone Density:
Miriam Nelson and Sarah Wernick, Strong Women, Strong Bones, Perigee Trade, 2006.

Medical history:

• family history of osteoporosis

• previous bone fracture

• race (Caucasian and Asian have 30% greater risk)

• began menstruation after 15 or ended periods before 45

• ovary removal

• ammenorrhea during menstruating years

• small bone structure

• low estrogen

• frailty from aging or illness

• being a woman

Illnesses:

• rheumatoid arthritis (increases osteoclast activity)

• hyperthyroidism or overmedicated hypothyroidism (increases osteoclast activity)

• parathyroid disorder (excess increases osteoclast activity)

• poorly controlled diabetes

• lactose intolerance

• chronic digestive problems (poor mineral absorption).

Medications:

• steroids

• excessive thyroid hormone

• anti-convulsants

• diuretics

• aluminum containing antacids (Rolaids, Maalox, Mylanta, Di-Gel, Gelusil)

• birth control pills (decreases estrogen)

Life style:

• sedentary

• poor nutritional status

• low Ca and Vitamin D

• low fruit and vegetable intake

• more than 7 alcoholic drinks/wk

• more than 4 small cups of coffee/day, 10 cups tea, or 400 ml caffeine from soda (over 400 ml a day doubles risk of osteoporosis—diuretic, increases urinary excretion)

• current or former smoker (decreases estrogen levels)

• history of dieting or eating disorders (rapid weight loss releases excessive parathyroid hormone which leads to bone breakdown, plus poor nutritional support)

Risk Factors For Fracture (as opposed to bone mineral density):

Cummings, Steven, et al., “Risk Factors for Hip Fracture in White Women,” The New England Journal of Medicine 332.12 (1995): 767-774 (Brown p. 213):

1.   Current use of anti-convulsant drugs
2.   Inability to rise from chair without using arms
3.   History of maternal hip fracture (before age 80)
4.   Previous hyperthyroidism
5.   Current use of tranquilizers and mood altering drugs
6.   Resting pulse over 80 beats per minute
7.   Poor overall self-rated health
8.   Stand less than 4 hours a day
9.   Advancing age
10. Fracture since age 50
11. Weigh less than you did at 25
12. Current caffeine intake over 300 mg/day (15-20 ounces of coffee--caffeine is diuretic and causes calcium loss)
13. Poor distant depth perception (severe vision impairment)
14. Low-frequency contrast sensitivity (impaired vision)
15. Shorter than at age 25
16. Lack of exercise
17. Low bone density

In this study, other risk factors were smoking, current thyroid medication, having fallen in previous year, poor neuromuscular function, low body weight, poor functional-status score

© 2004 Elaine Mansfield