Dr. Verna Brooks-McKenzie. - Winston Sill/ Freelance Photographer

Friday October 20 is 'World Osteoporosis Awareness Day' and the following was submitted by Dr. Verna Brooks McKenzie, the founder and president of Jamaica Osteoporosis Society

Osteoporosis is a disease in which the density and quality of bone, are reduced, increasing the risk of fracture after a minor bump or even in the course of normal daily activities such as giving a hug. There are usually no symptoms until the first fracture occurs. Fractures, particularly those of the hip and spine, cause suffering, lasting disability and a greatly diminished quality of life. Only one third of spine fractures are associated with clinical signs and there is a high rate of failure of identifying these fractures on X-rays.

It is estimated that over 200 million people worldwide have osteoporosis. This is a major public health problem with enormous social and economic impact. Hip fractures are predicted to increase worldwide (one in three women, and one in five men over the age of 50 years). They are more costly, resulting in a greater disease burden especially in the elderly. Although osteoporosis can be easily diagnosed and treated, it remains seriously underdiagnosed and undertreated.

Hip fractures

Approximately 1.6 million hip fractures occur worldwide each year and by 2050, this number could reach between 4.4 million and 6.3 million. In women over 45, osteoporosis accounts for more days spent in hospital than many other diseases including diabetes, myocardial infarction and breast cancer (IOF annual report 2005). Women who develop a vertebral fracture are at substantial risk for additional fracture within the next year.

Male osteoporosis is rarely recognised and treated even after a fracture has occurred because many men think it is a woman's disease. Advanced age is the best predictor of osteoporosis but early menopause, maternal history of hip fracture, low body weight, fracture after age 40 or specific diseases and certain medication (e.g. prednisone) increase the risk of fracture. These fractures impose a considerable financial burden on health services due to decreased mobility, hospitalisation and nursing home requirements. The numbers of women with osteoporosis and fractures will continue to increase as the elderly population expands, unless preventative measures are taken.

Generally speaking, your risk for osteoporosis and fracturing depends on your bone health - the size and strength of your bones and the condition of your bone tissue. Bone health is as a result of how well your skeleton developed during childhood and early adulthood and how much bone was present at the time of your peak bone mass, usually by age 30.

Bone density testing

It used to be that the only way to detect the disease was when you broke a bone. Bone density testing can establish your baseline bone density values, determine the severity of your low bone density and confirm that you have osteoporosis. The frequency of retesting depends on your age and the factors that put you at risk. One-two years is the minimum amount of time for bone affected by osteoporosis to show a noticeable increase or decrease in density.

It is never too early to start the battle against osteoporosis or too late to stop the condition in its tracks. Ideally, prevention starts in childhood and continues throughout life. The more you build up your bones during your early years, the less likely you are to develop osteoporosis later. Good bone health starts with good nutrition. Avoiding smoking and being physically active on a regular basis are key components of any action plan to prevent or treat osteoporosis.

Diagnosis and intervention should initially be aimed at people with the highest risk. Research is ongoing for several treatments - that may prevent bone breakdown or stimulate the formation of new bone - that are effective, easy to take, have few side effects and are inexpensive.