Osteoporosis and Older Adults : What can you do

by National Institute on Aging

(Page 2 of 2)

Medicines. Some common medicines can make bones weaker. These include a type of steroid drug called glucocorticoids used for arthritis and asthma, some antiseizure drugs, certain sleeping pills, treatments for endometriosis, and some cancer drugs. An overactive thyroid gland or using too much thyroid hormone for an underactive thyroid can also be a problem. If you are taking these medicines, talk to your doctor about what you can do to help protect your bones.

Lifestyle. Smoking increases loss of bone mass. For this and many other health reasons, stop smoking. Limit how much alcohol you drink. Too much alcohol can put you at risk for falling and breaking a bone.

What Can I Do for My Osteoporosis?

Treating osteoporosis means stopping the bone loss and rebuilding bone to prevent breaks. Diet and exercise can help make your bones stronger. But they may not be enough if you have lost a lot of bone density. There are also several medicines to think about. Some will slow your bone loss, and others can help rebuild bone. Talk with your doctor to see if one of these might work for you:

Bisphosphonates. These medicines slow the breakdown of bone and increase bone density. They can make it less likely that you will break a bone, most of all in your spine, hip, or wrist. Side effects may include nausea, heartburn, and stomach pain. A few people have muscle, bone, or joint pain while using these medicines. These drugs must be taken in a certain way-when you first get up, before you have eaten, and with a full glass of water. You should not lie down, eat, or drink for at least one-half hour after taking the drug. Even if you follow the directions closely, these drugs can cause serious digestive problems, so be aware of any side effects. These pills are available in once-daily, once-a-week, and once-a-month versions.

Raloxifene. This drug is used to prevent and treat osteoporosis. It is a SERM (selective estrogen receptor modulator). It prevents bone loss and spine fractures but may cause hot flashes or increase the risk of blood clots in some women.

Estrogen. Doctors sometimes prescribe this female hormone around the time of menopause to treat symptoms like hot flashes or vaginal dryness. Estrogen also slows bone loss and increases bone mass in your spine and hip, so women can use it to prevent or treat osteoporosis. But, estrogen use is thought to be risky for some women. Talk to your doctor. Ask about the benefits, risks, and side effects, as well as other possible treatments for you.

Calcitonin. This hormone increases bone mass in your spine and can lessen the pain of fractures already there. It comes in two forms-a shot or nasal spray. The shot may cause an allergic reaction and has some side effects like nausea, diarrhea, or redness in your face, ears, hands, or feet. The only side effect of the nasal spray is a runny nose in some people. Calcitonin is most useful for women who are 5 years past menopause.

Parathyroid hormone (PTH). Also called teriparatide, this shot is given daily for up to two years to postmenopausal women and men who are at high risk for broken bones. It improves bone density in the spine and hip. Common side effects include nausea, dizziness, and leg cramps.

Can I Avoid Falling?

When your bones are weak, a simple fall can cause a broken bone. This can mean a trip to the hospital and maybe surgery. It might also mean being laid up for a long time, especially in the case of a hip fracture. So, it is important to prevent falls. Some things you can do are:

• Make sure you can see and hear well. Use your glasses or a hearing aid if needed.
• Ask your doctor if any of the drugs you are taking can make you dizzy or unsteady on your feet.
• Use a cane or walker if your walking is unsteady.
• Wear rubber-soled and low-heeled shoes.
• Make sure all the rugs and carpeting in your house are firmly attached to the floor, or don't use them.
• Keep your rooms well lit and the floor free of clutter.
• Use nightlights.

You can find more suggestions in the National Institute on Aging's Preventing Falls and Fractures Age Page, also available from the National Institute on Aging Information Center listed in the resource section.

Do Men Have Osteoporosis?

Osteoporosis is not just a woman's disease. Not as many men have it as women do, but men need to worry about it as well. This may be because most men start with more bone density than women and lose it more slowly as they grow older.

Experts don't know as much about this disease in men as they do in women. However, many of the things that put men at risk are the same as those for women:

• family history
• not enough calcium or vitamin D
• too little exercise
• low levels of testosterone
• too much alcohol
• taking certain drugs
• smoking.

Older men who break a bone easily or are at risk for osteoporosis should talk with their doctors about testing and treatment. Men can use bisphsphonates or parathyroid hormone to increase bone density. Testosterone supplements may help some men with low levels of testosterone.

About the Author

www.nia.nih.gov
NIA, one of the 27 Institutes and Centers of NIH, leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.