By Dr. Bart Williams
Dr. Bart Williams is director of Van Andel Research Institute’s Center for Cancer and Cell Biology. He is an expert in bone biology and studies the building blocks of bone growth on behalf of the millions suffering from diseases such as osteoporosis. He seeks new ways of altering cell signaling pathways to encourage healthy bone development and deter cancer spread to the skeleton.
What is osteoporosis? And what causes it?
Osteoporosis is a disease that causes the bones to become porous and weak, resulting in painful breaks that may be caused by something as simple as a sneeze or gentle bump. The risk of osteoporosis increases with age in all people; however, women are more likely to have osteoporosis or low bone density—about one in two women compared to one in four men. Overall, about 10 million people in the U.S. have osteoporosis.
Why is osteoporosis problematic?
The answer is simple—weak bones are more likely to break. In seniors, the group most impacted by osteoporosis, repairing these breaks can be a long, challenging road.
The biggest concern of all is hip fractures, which account for more than 50 percent of osteoporosis-related hospitalizations. These devastating breaks are incredibly difficult to repair, often requiring major surgery and extensive rehabilitation. Sadly, about 20 percent of people who suffer a broken hip pass away within a year of the injury and more than 50 percent require specialized residential care. All in all, it’s a difficult recovery compounded by limited mobility and increased risk of a subsequent break.
A growing concern
The world’s population is aging and that means age-related diseases such as osteoporosis will likely increase in the coming years.
As The New York Times reported in last June, physicians and other medical professionals alike are specifically worried about an impending public health crisis linked to osteoporosis-related bone fractures. Fueled by concerns over rare side effects, a staggering number of patients have stopped taking the most common medication for the condition, a group of drugs called bisphosphonates which includes medicines like Fosamax (Alendronate), Boniva (Ibandronate), and Actonel (Risedronate). This potentially increases their risk for osteoporosis-associated fractures later on. Between 2008 and 2012, the use of these medications plummeted by about 50 percent; a fact that was highlighted in a 2016 The New York Times article by Gina Kolata.
These very rare side effects include spontaneous fractures of the thighbone (10 to 40 in 100,000 patients) and deterioration of the jaw bone (fewer than one in 100,000). However, the risk of an osteoporosis related break is much higher—half of women over the age of 50 will experience such a fracture at some point in their life. Appropriate treatment can cut that risk significantly.
All treatment decisions should be made in consultation with an individual’s physician, who can provide information on risk factors and therapeutic strategies specific to each patient. It is also important to balance risk and speak to a physician about any concerns.
For younger people, it’s important to realize that building strong bones early in life is incredibly important. This involves a healthy diet with enough calcium and vitamin D as well as exercise.
On Wednesday November 15, the Institute will hold A Conversation About Osteoporosis: An Impending Public Health Crisis hosted by Carol Van Andel, a community event aimed at providing information about osteoporosis research and treatment. Stay tuned for more details!