BUILDING STRONGER BONES

   How to reduce risks and why older people need to take steps to prevent and treat bone loss needs to be considered.  For years it has been felt that Caucasian women were the group most at risk for brittle-bone disease.  It has now been determined that up to one quarter of hip fractures are men.  Their one-year survival rate is lower than that of women with the same injury.  According to Stavros Manolagas, M.D., Ph.D., professor at the University of Arkansas for Medical sciences in Little Rock, researchers have “put blinders on and focused almost exclusively on compensating for the loss of estrogen at menopause, but men also lose bone and, for most of their lives, at about the same rate as women.”  Recent research by Manolagas, director of the university’s Center for Osteoporosis and Metabolic Bone diseases, and others has led to a broader view about the factors responsible for bone loss and where and when to target prevention and treatment.

   Even bone mineral density testing, considered the standard measure for determining fracture risk, has proven to be a less central determinant of bone strength than researchers once thought.  “If you think of it from an engineering point of view, the strength of the structure depends on several components, like the size and shape of the bone, not just strong building material,” says Angela M. Cheung, M.D., Ph.D., founding director of the osteoporosis program at the University of Toronto.  Bone density remains the best measurement of determining risk, but newer assessment tools consider other factors that contribute to it.  Age, low body mass, and lifestyle factors should be considered.”

   Regular exercise and type of work are part of the implications of this living tissue that is constantly in a state of flux, with old bone being reabsorbed and new bone forming in its place.  Until around age 25 people build more bone than they lose.  Then the balance tips toward the loss, with women experiencing a more rapid decline during the first few years after menopause.  “The honeycomb-like inner layer of bone, which provides a lot of structural support, starts declining immediately after people reach their peak bone mass,” Manolagas says.  The harder outer layer becomes more porous and that can lead to fracture risk.  It appears that now the way of communicating while just sitting does not provide the needed type of exercise.  The “finger exercise” of texting while seated could be exchanged for a brisk outdoor walk while discussing business or social affairs.