Who is at Risk?
Improving the odds through patient identification
Healthcare professionals have a unique opportunity to identify and help affected patients manage osteoporosis and osteopenia, perhaps even help prevent a debilitating fracture. But the process begins with uncovering the condition and making an initial diagnosis.
Help improve bone health within your practice!1
Take a proactive approach to uncover currently undiagnosed osteoporosis / osteopenia patients within your practice
Identify patient dietary habits and lifestyles that have a negative impact on bone health
Understand and develop your recognition of all bone health risk factors
Understand when screening is important and for whom
Be familiar with the treatment of osteoporosis and osteopenia, and actively treat them when it is appropriate
Understand the impact and importance of compliance in the achievement of treatment goals
Counsel patients to take active steps to improve and maintain their bone health
Identifying key risk factors is important1
| General Risk Factors For Osteoporosis and Osteopenia |
| Heredity |
- Family history of osteoporosis (mother, father, grandparent, sister, brother, aunt)
- Family history of hip fracture
- Low trauma fracture in patient or in first-degree relative
|
| Ethnicity |
- Caucasian and Asian postmenopausal women
- Hispanic women are the fastest growing risk segment — risks almost as high are the Caucasian and Asian women
- African-American women are at high risk for osteopenia, but at a slightly lower risk for osteoporosis
|
| Menstrual History |
- Postmenopausal estrogen deficiency
- Premature menopause (before 45)
- Age 15 or older when menstruating started
- Amenorrhea
|
| Lifestyle Factors |
- Sedentary lifestyle
- Yo-yo dieting (losing and/or gaining 15 lbs. or more)
- History of anorexia or bulimia
- Cigarette smoking
- Excessive alcohol consumption
|
| Poor Diet |
- Excessive consumption of protein
- Limited consumption of dairy products
- High consumption of foods containing oxalic acid (e.g., spinach and some other green vegetables)
- High consumption of grains containing phytates (e.g., wheat, bran, soy protein isolates)
- Eating less than 5 servings of fruits/vegetables
- Lifelong low calcium intake
|
| Personal and Physical Factors |
- History of osteoporosis or fracture as an adult
- Frequent falls
- Small, thin frame
- Advancing age
- Impaired vision despite correction
- Currently smoking
- Poor health/frailty
- Dementia
|
Some medical conditions may increase risk1
| Medical Condition Risk Factors for Osteoporosis / Osteopenia |
| Arthritis |
Rheumatoid arthritis and other autoimmune connective tissue |
| Endocrine |
Hyperparathyroidism, hypogonadism, hyperprolactinemia, acromegaly, hypercortisolism, hyperthyroidism |
| Gastrointestinal |
Inflammatory bowel disease (IBD), Celiac disease, malabsorption syndromes, bariatric surgery |
| Liver |
Biliary sclerosis, sclerosing cholangitis, autoimmune hepatitis, alcoholic cirrhosis |
| Dietary disorders |
Anorexia nervosa/bulimia, inadequate diet, weight loss, calcium deficiency, excessive alcohol, excessive vitamin A (retinol), total parenteral nutrition |
| Neurologic |
MS, Stroke, Parkinson's disease, spinal cord injury, long-term immobilization |
| Kidney |
Renal disease |
| Diabetes |
Insulin-dependent diabetes mellitus |
| Other |
Organ transplantation, possibly idiopathic scoliosis |
Some medications may increase risk of1
- Glucocorticoids (oral and high-dose inhaled)
- Suppressive doses of glucocorticoids
- Aromatase inhibitors (letrozole, exemestane, anastrozole)
- Gonadotropin-releasing hormone agonists (lupron, lupron depot, LH-RH agonists, leuprolide)
- Immunosuppressants
- Anticonvulsants (phenobarbital, phenytoin)
- Cytotoxic drugs
- Lithium
- Long-term heparin use
- Depo-Provera
- Total parenteral nutrition
- PPIs
- SSRIs (antidepressants)