Parampal Gill, M.D.

Osteoporosis is a significant conical problem associated with loss of bone in our elderly women resulting in fractures of vertebrae and of legs.

Twenty-five percent of women over 60 years of age have documented spinal compression fractures in association with osteoporosis (1). As many as 50% of women will develop vertebral fractures by age 75 (2). The risk of hip fractures increases with age and reaches 20% by age 90 and 80% of hip fractures are found to be related to preexisting osteoporosis (3). Approximately 16.7% of women with hip fractures die within 3 months following their fractures (4). After age 45, there is a marked increase in the incidence of forearm fractures. By age 60, there are ten times more forearm fractures in women than in men of comparable ages (5). In the United States it is estimated that over 120,000 hip fractures occur in elderly women each year. The cost of treating these fractures, which are felt to result directly in 50,000 deaths per year, exceeds $2 billion annually.

Radiographs of the vertebral spine bones are the customary techniques used to identify loss of bone density associated with aging. The new photo absorption methods are now available in some centers and will become more widely available in the near future. These are presently the preferred methods of determining the bone mineral density.

Prevention for osteoporosis consists of balanced diet, regular exercise, physical therapy and medicinal intervention. For women over 50 years of age, balanced diet containing 8001200 mgs. Of elemental calcium a day is needed to maintain calcium balance. Physical activity for the sake of fitness should be encouraged.

Although the role of estrogen therapy in osteoporosis is disputed, a large body of evidence supports the possibility of a causal relationship between estrogens. Deprivation and acceleration of loss of bone mass with the concorutant increased risk of fractures. Low dose estrogen therapy can arrest or retard bone loss if this therapy is begun shortly after menopause (change of life).

Dosages of conjugated equine estrogen (0.625 mgs. daily) or ethanol estradiol (20 mg.) daily have been shown to be effective. Estrogens may have an adverse effect on some patients going on estrogen. Therapy should be thoroughly evaluated.

Prevent osteoporosis to prevent the loss of $2 billion to the nation annually.

Article extracted from this publication >> February 8, 1985