Osteoporosis is an Impending Public Health Crisis in Aging America

This column was originally published on The Hill on October 20, 2022.

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There is a bone health crisis in America. More than 50 million Americans are at risk of developing osteoporosis, and 10 million already have it. Full 80 percent of these people are women. In fact, one in five women over the age of 50 will develop the disease in their lifetime.

Yet, despite its prevalence, osteoporosis is known as a “silent disease.” The nickname comes from the fact that people have increasingly brittle bones that are prone to breaking without knowing or feeling their bone density decrease. But the name is also appropriate because there is still little awareness of osteoporosis, how to prevent or delay its onset, and what to do once it’s diagnosed.

But on that World Osteoporosis Day, we can change that. And we have to try because the consequences of osteoporosis-related fractures are very severe for many women, their families, and our nation as a whole.

Our bones are made up of living tissue that is constantly being broken down and renewed. Osteoporosis is when the body loses old bone tissue faster than new tissue. settings. At this stage, the remaining bones can become so weak and brittle that simple gestures can cause a bone fracture such as yawning, twisting, bending over, coughing, hitting something, or a minor fall.

These broken bones – mostly in the hip and spine – are dangerously common. according to a 2021 report About 1.8 million Medicare beneficiaries commissioned by the Bone Health and Osteoporosis Foundation experienced approximately 2.1 million osteoporotic fractures in 2016. world by 2050.

Women are particularly at risk for osteoporosis and experience rapid bone loss as estrogen levels fall, especially within five to seven years after menopause. Even women can lose 20 percent Ultimately, 50 percent of women are likely to break a bone from the disease.

Hip fractures are particularly dangerous. Women’s risk of hip fracture due to osteoporosis is equal to the risk of breast, uterine and ovarian cancer. combined. Yes, you read it right.

And that’s not all. More women die from complications following hip fractures each year than from breast cancer. Of women over 50 who have a hip fracture, 25 percent die within one year of the injury, 50 percent will never be able to walk independently again, and 20 percent have to be permanently moved to a nursing home. As a result, these osteoporotic fractures cause more hospitalizations and higher healthcare costs than heart attacks, strokes or breast cancer in women 55 and older.

The economic burdens of this disease are also significant. Total annual cost of providing care to Medicare beneficiaries suffering osteoporotic fractures, 57 billion dollars This number includes direct medical costs as well as indirect societal costs resulting from loss of productivity and informal care. These costs are expected to increase More than $95 billion by 2040. With America’s aging populationThis should alarm everyone.

But it doesn’t have to be this way. Managing osteoporosis is within our capabilities. We know that diets rich in calcium and vitamin D can help keep bones strong. Avoiding caffeine, excess salt, alcohol, and smoking—all of which can either contribute to bone loss or increase the risk of fractures—is essential. Weight-bearing and muscle-strengthening exercise is also very important. In fact, strength training can both soften and delay bone loss, as well as make bones stronger.

But these are not our only tools. Preventive bone density scans, or dual-energy x-ray absorptiometry scans (DXA for short), are easy, painless, and inexpensive. They are also incredibly effective. DXA scans can predict broken bones better than a cholesterol test can predict heart attacks or stroke by measuring someone’s blood pressure. As it turns out, Medicare beneficiaries with DXA bone density testing experience 35 percent fewer hip fractures and 22 percent fewer fragility fractures.

The problem is that very few people at risk for osteoporosis get these scans. In 2007, Medicare stopped paying for in-practice scans, and there has been a drastic decline in the number of patients receiving scans since then. According to the Fracture Prevention Coalition, reduced access to DXA scans conveniently performed in a doctor’s office since 2008 has meant: 7 million fewer women Bone densities were tested. Unless something is done, this number will increase even more.

These alarming statistics are why it’s absolutely critical for Congress to pass HR 3517. Act 2021 to Increase Access to Osteoporosis Testing for Medicare Beneficiaries, without delay. This bill will increase access to DXA scans for Medicare beneficiaries by reinstating Medicare funding for the procedure. When patients are diagnosed and treated more quickly and accurately, they will be better equipped to take care of themselves and their long-term health. Increasing tests will reduce the number of preventable osteoporotic fractures and will reduce the astronomical health costs of our country.

Millions of people, especially women, who see osteoporosis as such a serious risk cannot wait any longer for this bill. Their health, and often their life, depends on it.

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