Bone loss to endanger half of seniors by 2020, US study says
WASHINGTON -- Half of Americans older than 50 will be at risk of fractures from too-thin bones by 2020, the surgeon general warned yesterday, urging people to get more calcium, vitamin D, and exercise to avoid crippling osteoporosis.
The bone-thinning disease is on the rise as the population grays -- but weak bones are not a natural consequence of aging, Surgeon General Richard Carmona stressed.
Strong bones begin in childhood, and years of eating right and physical activity can leave even 80-somethings with sturdy bones. But Carmona said too few Americans follow that prescription, setting the stage for worrisome increases in broken hips and other fractures as more people pass their 50th birthday.
''Osteoporosis isn't just your grandmother's disease," Carmona said in releasing the first surgeon general's report on bone health. ''We all need to take better care of our bones."
Osteoporosis affects an estimated 10 million Americans, and each year about 1.5 million suffer a fracture as a result. And 34 million other Americans have less severe bone-thinning but enough to risk a fracture.
By 2020, about 14 million people older than 50 are expected to have osteoporosis and 47 million others will have low bone mass, the report says.
Women are at highest risk, especially white women, and particularly after menopause, when estrogen levels -- which also help keep bones strong -- plummet. But osteoporosis affects men, too, and people of all races.
The disease is underdiagnosed because many people do not know their bones are thinning until one breaks.
Doctors often are just as guilty in overlooking the risk, sometimes forgetting to check bone density when middle-age or older patients are treated for fractures.
Consider hip fractures. About 20 percent of seniors who suffer one die within a year, partly because the break often triggers a downward spiral of inactivity, depression, and other problems. But the report cited one study that found fewer than a quarter of hip-fracture patients were given calcium and vitamin D supplements to help build up their bones -- or a bone-density test to check the severity of their bone-thinning.
Bone health is a balancing act: Cells called osteoclasts dissolve old, worn-out bone while other cells called osteoblasts form new bone. Peak bone formation occurs before 30, and the bone-building cells gradually can slow down over the ensuing decades.
A number of drugs treat osteoporosis, either by slowing bone breakdown or encouraging new bone formation.
But Carmona said the main focus must be on preventing thinning bones, not on medication. ''If we let it get that far, we probably missed the boat."
Among his report's recommendations:
