Osteoporosis, Fragility & Bone Health Edition | Osteoporosis “Getting to the Core”
Oct 19, 2023
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Jad Sfeir, an osteoporosis expert, discusses the importance of early detection of osteoporosis and the available treatment options. Topics include the prevalence of osteoporosis in women, the economic burden of hip fractures, simple screening tests, and the pathophysiology of osteoporosis. The podcast also covers bone density changes with age, interpreting bone mineral density results, risk stratification, and fracture prevention.
Osteoporosis is prevalent in women, with hip fractures being a major complication.
Screening tests can detect osteoporosis, and treatment options are available to manage the condition and reduce fracture risk.
Deep dives
Overview of Osteoporosis
Osteoporosis is a common condition, affecting about 20% of women in the U.S., with hip fractures being a major complication. Screening tests can detect osteoporosis, and various treatment options are available to manage the condition and reduce fracture risk.
Bone Density Changes with Age
Bone density changes throughout our lives, with peak bone mass achieved in our 20s and 30s. After the age of 50, there is a slow loss of bone density. Menopause accelerates bone loss in women, while men usually experience clinically noticeable bone loss in their 60s and 70s.
Pathophysiology of Osteoporosis
Osteoporosis involves an imbalance between bone formation and resorption. Osteoblasts, which form bone, are reduced in number and more susceptible to apoptosis with age, while osteoclasts, which resorb bone, are increased. The shift in bone marrow stem cells towards adiposity may contribute to this imbalance.
Screening and Treatment Recommendations
Screening for osteoporosis is recommended for women over 65 and men over 70, with additional screening for women over 50 with clinical risk factors or a history of fractures. The gold standard test for screening is a DEXA scan. Treatment options include calcium and vitamin D supplementation, exercise, and pharmacologic therapy, such as bisphosphonates and denosumab.
80% of those with osteoporosis are women and many have no idea they have it. While a variety of bone fractures can result from osteoporosis, hip fractures are the most serious complication. They represent a significant economic burden and often result in major changes to an individual’s lifestyle. The good news is osteoporosis can be detected with relatively simple screening tests and we now have a variety of treatment options available to manage the condition and reduce the risk of fracture. The topic for this podcast is osteoporosis, and our guest is Jad Sfeir, M.D., M.S., an endocrinologist at the Mayo Clinic. We’ll discuss the pathophysiology of osteoporosis, who and when to screen and the latest management options.