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Osteoporosis: What You Need to Know About This "Silent Disease"

Q&A with Kathleen Breda, NP, MSN, Manager, Geriatric Fracture Program

Osteoporosis is a silent disease that can affect  anyone regardless of age and gender.

According to the National Osteoporosis Foundation, an estimated 10 million people in the United States have osteoporosis, a disease that causes weak, thinning bones.

In recognition of Osteoporosis Awareness Month, Cedars-Sinai Newsroom sat down with Kathleen Breda, MSN, orthopaedic nurse practitioner and manager of the Geriatric Fracture Program at Cedars-Sinai, to share recommendations on how to detect, treat and prevent osteoporosis.

Newsroom: What is osteoporosis?

Breda: Osteoporosis literally means porous bones, which means something that is full of holes. Osteoporosis is a disease that we don't feel, but it weakens bones, making them more likely to break or fracture.

Newsroom: Who is at risk of developing osteoporosis?

Breda: One in two women over the age of 50, and one in four men over the age of 50, will develop osteoporosis, but the disease can affect people of any age.

There are several reasons why people develop osteoporosis, In women, it has a lot to do with the lack of estrogen after menopause. In men, it can be related to other illnesses or low testosterone. And in all sexes, it has a lot to do with habits such as whether you smoke, drink heavily or do not exercise.

Medication also can be a factor in developing osteoporosis, as certain medications may contribute to bone loss.

Some people are genetically predisposed to osteoporosis, which is why it's important to know your family history.

Newsroom: Is osteoporosis preventable?

Breda: In some cases, it is. The key is trying to reduce the risk of osteoporosis, through a healthy lifestyle. It is also important to reduce the risk of falls, which can result in fractures and poor quality of life.

A few good first steps are to:

  • Eat a diet rich in calcium (sardines, dairy products, broccoli), which strengthens bones, and take vitamin D (contained in foods such as salmon, milk and yogurt), which gets calcium to the bones.
  • Avoid smoking and limit alcohol consumption to one drink a day.
  • Exercise regularly doing weight-bearing activities, such as lifting weights, to build core and leg muscles.

Not everybody develops osteoporosis, but you are never too old or young to take care of your bones.

Newsroom: How can you tell if you have osteoporosis?

Breda: Poor bone quality can be surprising, it's a silent disease.

The only way that you can know if you have osteoporosis is to talk with your primary care physician, have the doctor evaluate you and have him or her order a bone density scan, the gold standard for determining bone quality.

Based on those results, you can make some good decisions about what you can do to prevent fractures.

Newsroom: What is the Geriatric Fracture Program at Cedars-Sinai?

Breda: Suffering a broken bone can drastically change an older person's life, leading to hospitalizations, surgery, chronic pain and loss of independence. The Geriatric Fracture Program was developed to optimize the care of adults 65 and older who have sustained a fracture or broken bones. The team consists of a nurse practitioner, a transitional care coordinator, a bone health coordinator and a geriatric fraction researcher. The program aims to improve bone-fracture outcomes through the four M's model:

  1. Meaning: We discuss what matters most to the patient and their family in relation to their care and rehabilitation.
  2. Medications: We review past and current medications to make sure that medications did not contribute to the fall that caused the fracture. We also want to make sure that we don't give patients medications that could cause more problems.
  3. Mobility: We spend a great deal of time making sure that patients gain greater mobility in the hospital and get the appropriate rehab they need once they've left the hospital. We practice being up out of bed, walking with assistance, getting up  and into a chair to eat meals, etc.
  4. Mental Health: We monitor mental activity. Unfortunately, about 50% of adults who have sustained a hip fracture have delirium, a temporary confusion. The condition can be caused by pain, dehydration, infection or drug and alcohol withdrawal, and results in longer hospital stays, more complications and increased risk of death if not managed.

Once patients leave the hospital, we follow up for 30, 60 and 90 days to ensure that our each patient’s recovery is going well.

Read more on the Cedars-Sinai blog: Preventing Falls in Older Adults