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Boomers, Generation X-ers and Bones

By Jill Feffer, MD, Endocrinology, Diabetes and Metabolism, CareMount Medical
May 18, 2021

If you’re a Baby Boomer or even an older Generation Xer, during your routine medical checkups you and your provider should talk about your overall physical and mental health from head to toe and everything in between. As you age, a key part of that discussion should be about bone health. It’s very important to learn whether you’re at risk for osteoporosis, a disease that weakens bone and can place you at high risk for fracture.

Bone density loss that can lead to osteoporosis begins in our thirties when the body’s production of new bone to replace old bone begins to decrease and slow down. Over several decades, once strong bones can become porous, brittle, and increasingly fragile. Osteoporosis is a silent disease. In fact, many people are unaware they have it unless it’s been detected by a bone mineral density (BMD) scan or until they fracture a bone – most commonly the hip, spine, forearm or wrist.

Who’s Most at Risk?

More than 10 million Americans have osteoporosis and more than four times that number are at risk because they have low bone density according to the National Osteoporosis Foundation. Simply getting older is the greatest risk factor for osteoporosis in women and men regardless of race, but it is more common in white and Asian women over 50. According to the U.S. Centers for Disease Control and Prevention (CDC) the disease affects nearly 20 percent of women and almost 5 percent of men over age 50.

Starting with menopause, women may lose bone rapidly for several years. The pace of bone loss eventually slows down but it does continue. Men experience bone loss more slowly than women, but by 65 or 70, men and women lose bone at about the same rate. Common risk factors for fracture, specific to women are early menopause or having had surgery to remove their ovaries prior to menopause. Low levels of testosterone increase risk in men.

Risk factors for women and men include:

  • family history of broken bones or osteoporosis
  • breaking a bone after age 50
  • having had extended bed rest or being physically inactive
  • tobacco use (smokers may absorb less calcium from their diets)
  • heavy alcohol use (at least 3 drinks/day)
  • taking certain medications, including some for arthritis and asthma plus some cancer drugs
  • long term use of certain medicines such as corticosteroids
  • having a small body frame
  • getting too little calcium and/or vitamin D over many years

It’s also a good idea to ask your doctor if you are a candidate for a bone density test. The CDC and the Endocrine Society similarly recommend BMD screening with a DEXA scan for women over 65, men at high risk older than 70, and for women and men age 50+ who have certain risk factors (including a parent who has broken a hip).

Here are some tips for what you can do to protect your bones and lower your osteoporosis risk: avoid alcohol; quit smoking; eat a diet rich in calcium and make sure your body has enough vitamin D (your physician may do a blood test to find out and if necessary, recommend dietary supplements). Finally, get regular exercise. If your doctor says it’s ok, combine strength training with weight-bearing and balance exercises. Strength training helps strengthen muscles and bones in your arms and upper spine; and weight-bearing exercises — such as walking, jogging, running, stair climbing, skipping rope, skiing — affect mainly the bones in your legs, hips and lower spine. Balance exercises such as tai chi can reduce your risk of falling, especially as you get older.

If you want to learn more about your risk of osteoporosis, get in touch with your primary care physician. He or she may suggest a visit or, depending upon your health status, may recommend that you see a specialist who screens, diagnoses and treats osteoporosis.  That might be an endocrinologist who treats metabolic bone conditions and for women it might be their gynecologist.

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