Month: May 2015

New research shows men are less likely to be screened or take protective measures.

While the consequences of osteoporosis are worse in men than women – including death – older males are far less likely to take preventive measures against the potentially devastating bone-thinning disease or to accept recommendations for screening, according to startling new research by North Shore-Long Island Jewish Health System geriatricians.

Geriatric fellow Irina Dashkova, MD, designed and led a cross-sectional survey of 146 older adults in New York and Florida that showed stunning gender differences in perspectives, beliefs and behaviors surrounding osteoporosis, which primarily affects women, but also affects up to two million American men. Another eight million to 13 million men in the United States have low bone mineral density, a condition known as osteopenia that’s a precursor to osteoporosis.

“We were surprised at how big a difference we found between men and women regarding osteoporosis,” said Dr. Dashkova, lead author of the study, which was presented at the American Geriatrics Society’s 2015 Annual Scientific Meeting in May.

“The fact that longevity is increasing in our population is wonderful. But we know from research that when men suffer fractures, their mortality is higher than in women and that severe medical consequences and loss of independence are much more prevalent in men.” She added, “In our environment, you just get this perception that osteoporosis is a women’s problem. This has to be changed, and the sooner the better.”

More than 10 million Americans live with osteoporosis – raising their risk for serious bone fractures – and another 43 million have low bone mineral density, according to the National Osteoporosis Foundation. Prior research showed that 13 percent of white men in the United States older than age 50 will experience at least one osteoporosis-related fracture during their lifetime.

Strikingly, the risk of death after sustaining a hip fracture is twice as high in men compared to women, and loss of independence is also more common in males. Some medical conditions and drugs that can affect osteoporosis risk are male-specific, such as prostate cancer drugs that affect the production of testosterone or the way it works in the body.

Dr. Dashkova’s research, in which she collaborated with Gisele Wolf-Klein, MD, director of geriatric education for the North Shore-LIJ Health System, examined the psychological and social factors surrounding osteoporosis influencing each gender. The team found that while most women would accept osteoporosis screening if offered, less than 25 percent of men would. Women were also more than four times as likely as men to take preventive measures against osteoporosis, such as taking calcium and vitamin D supplements to strengthen bones.

Dr. Wolf-Klein, who is also program director for the geriatric fellowship at North Shore-LIJ, noted that osteoporosis testing involves a painless, quick procedure known as a DXA scan that shouldn’t be considered fearsome. But healthcare providers also aren’t encouraging men to undergo screening as often as they should, she said.

“Our survey clearly establishes that physicians are just not thinking of screening men. It’s only when older men fall and break their hip that someone thinks maybe we should do something to prevent them breaking the other hip,” Dr. Wolf-Klein said. “Not only is society in general unaware of the problem of osteoporosis in men, men are not seeking screening and diagnosis.”

“We geriatricians are delighted to see that longevity is increasing in both males and females,” Dr. Wolf-Klein continued. “The average age in my practice is in the 90s, and our patients are to be congratulated because clearly they’re doing something right. But we have a duty to make sure those later years are as happy and productive as can be and not spent in a wheelchair.”

During Men’s Health Month in June, Talk to Dad About Osteoporosis. Source: North Shore-Long Island Jewish (LIJ) Health System (www.northshorelij.com).

If you have a Facebook account, you are probably well aware of FarmVille, Candy Crush Saga, Diamond Dash, Bejeweled Blitz and a host of other social network games (SNGs). Most of us think of these games as a pleasant diversion at best, and, at worst, a waste of time. But did you know that today, these games help create connections among family members who are separated by distance—and sometimes, by years?

According to a recent study from Montreal’s Concordia University, published in the journalInformation, Communication and Society, more families are playing these games together, and it is a fun and meaningful way to interact—similar to the old board games many of us enjoy, but available to family members who aren’t able to sit across the table from each other.

Senior author Mia Consalvo says, “Maintaining those connections is especially important as families find themselves dispersed across countries and continents. SNGs give families a convenient and cheap way to transcend geographical boundaries.”

Consalvo and her team from Concordia’s Game Studies and Design department interviewed social network gamers about the ways they connected with family through gaming. The researchers reported, “These online games offer families a common topic of conversation and enhance the quality of time spent together, despite the fact that most SNGs don’t necessarily involve any direct communication.”

SNGs might also, in a sense, enlarge our family circle, as we connect with family members we’ve lost touch with—or have never even met. Chatty Facebook posts get us acquainted with distant cousins, and gaming with them helps cement the sense of family circle.

And the best news for seniors: the Concordia team calls social gaming “transgenerational.” Says Consalvo’s colleague Kelly Boudreau, “It’s not just siblings in their early 20s using SNGs to connect. Grandfathers are playing online games with granddaughters, mothers with sons. These multigenerational interactions prove social networks are tools that break down both communication and age barriers.”0

May Is Osteoporosis Awareness and Prevention Month. Try your hand at this month’s “Calcium for Bone Health” wordfind for a list of foods that contain this nutrient, which is so important for building strong bones.

Calcium-Sources-Wordfind 

Osteoperosis Puzzle Solution 

Osteoperosis and aging: Bones feel solid, but the inside of a bone is actually filled with holes like a honeycomb. Bone tissues are broken down and rebuilt all the time. While some cells build new bone tissue, others dissolve bone and release the minerals inside.

As we get older, we begin to lose more bone than we build. The tiny holes within bones get bigger, and the solid outer layer becomes thinner. In other words, our bones get less dense. Hard bones turn spongy, and spongy bones turn spongier. If this loss of bone density goes too far, it’s called osteoporosis. Over 10 million people nationwide are estimated to have osteoporosis.

It’s normal for bones to break in bad accidents. But if your bones are dense enough, they should be able to stand up to most falls. Bones weakened by osteoporosis, though, are more likely to break.

“It’s just like any other engineering material,” says Dr. Joan McGowan, an expert on osteoporosis from the National Institutes of Health (NIH). If you fall and slam your weight onto a fragile bone, “it reaches a point where the structures aren’t adequate to support the weight you’re putting on them.” If the bone breaks, it’s a major hint that an older person has osteoporosis.

Broken bones can lead to serious problems for seniors. The hip is a common site for osteoporosis, and hip fractures can lead to a downward spiral of disability and loss of independence. Osteoporosis is also common in the wrist and the spine.

The hormone estrogen helps to make and rebuild bones. A woman’s estrogen levels drop after menopause, and bone loss speeds up. That’s why osteoporosis is most common among older women. But men get osteoporosis, too.

“A third of all hip fractures occur in men, yet the problem of osteoporosis in men is frequently downplayed or ignored,” says Dr. Eric Orwoll, a physician-researcher who studies osteoporosis at Oregon Health and Science University. Men tend to do worse than women after a hip fracture, Orwoll says.

Experts suggest that women start getting screened for osteoporosis at age 65. Women younger than age 65 who are at high risk for fractures should also be screened. Men should discuss screening recommendations with their health care providers.

Screening is done with a bone mineral density test at the hip and spine. The most common test is known as DXA, for dual-energy X-ray absorptiometry. It’s painless, like having an X-ray. Your results are often reported as a T-score, which compares your bone density to that of a healthy young woman. A T-score of −2.5 or lower indicates osteoporosis.

There’s a lot you can do to lower your risk of osteoporosis. Getting plenty of calcium, vitamin D, and exercise is a good start, Orwoll says.

Calcium is a mineral that helps bones stay strong. It can come from the foods you eat—including milk and milk products, dark green leafy vegetables like kale and collard greens—or from dietary supplements. Women over age 50 need 1,200 mg of calcium a day. Men need 1,000 mg a day from ages 51 to 70 and 1,200 mg a day after that.

Vitamin D helps your body absorb calcium. As you grow older, your body needs more vitamin D, which is made by your skin when you’re in the sun. You can also get vitamin D from dietary supplements and from certain foods, such as milk, eggs, fatty fish, and fortified cereals. Talk with your health care provider to make sure you’re getting a healthy amount of vitamin D. Problems can arise if you’re getting too little or too much.

Exercise, especially weight-bearing exercise, helps bones, too. Weight-bearing exercises include jogging, walking, tennis, and dancing. The pull of muscles is a reminder to the cells in your bones that they need to keep the tissue dense.

Smoking, in contrast, weakens bones. Heavy drinking does too—and makes people more likely to fall. Certain drugs may also increase the risk of osteoporosis. Having family members with osteoporosis can raise your risk for the condition as well.

The good news is, even if you already have osteoporosis, it’s not too late to start taking care of your bones. Since your bones are rebuilding themselves all the time, you can help push the balance toward more bone growth by giving them exercise, calcium, and vitamin D.

Several medications can also help fight bone loss. The most widely used are bisphosphonates. These drugs are generally prescribed to people diagnosed with osteoporosis after a DXA test, or to those who’ve had a fracture that suggests their bones are too weak. Bisphosphonates have been tested more thoroughly in women, but are approved for men too.

Researchers are trying to develop drugs that increase bone growth. For now, there’s only one available: parathyroid hormone. It’s effective at building bone and is approved for women and men with osteoporosis who are at high risk for having a fracture.

Another important way to avoid broken bones is to prevent falling and occasions for fracture in the first place. Unfortunately, more than 2 million so-called fragility fractures (which wouldn’t have happened if the bones had been stronger) occur nationwide each year. “To reduce the societal burden of fracture, it’s going to take a combined approach of not only focusing on the skeleton but focusing on fall prevention,” says Dr. Kristine Ensrud, a physician-researcher who studies aging-related disorders at the University of Minnesota and Minneapolis VA Health Care System.

Many things can affect the risk for a fall, such as how good a person’s balance is and how many trip hazards are in the environment. The kind of fall matters, too. Wrist fractures often occur when a person falls forward or backward. “It’s the active older person who trips and puts her hand out,” McGowan says. Hip fractures often arise when a person falls to the side. Your hip may be strong enough to handle weight that goes up and down, but not an impact from another direction.

“That’s why exercise that builds balance and confidence is very good at preventing fractures,” McGowan says. For example, she says, tai chi won’t provide the loads needed to build bone mass, but it can increase balance and coordination—and make you more likely to catch yourself before you topple.

NIH-funded researchers are looking for better ways to tell how strong your bones are, and how high your chances are of breaking a bone. For now, though, the DXA test is the best measure, and many seniors, even older women, don’t get it, Ensrud says. If you’re concerned about your bone health, she adds, “Ask your health care provider about the possibility of a bone density test.”

Source: NIH News In Health, a publication of the National Institutes of Health. For more consumer health news, visit Health.nih.gov.

Older adults are a vital part of our society. Since 1963, communities across the country have shown their gratitude by celebrating Older Americans Month each May. The theme of this year’s celebration is “Get into the Act,” to focus on how older adults are taking charge of their health, getting engaged in their communities, and making a positive impact in the lives of others.

The theme also reflects on the 50th anniversary of the Older Americans Act. President Lyndon B. Johnson signed the Older Americans Act into law in July 1965. Since that time, the Act has provided a nationwide aging services network and funding that helps older adults live with dignity in the communities of their choice for as long as possible. These services include home-delivered and congregate meals, caregiver support, community-based assistance, preventive health services, elder abuse prevention, and much more.

By promoting and engaging in activity, wellness, and inclusivity, more Americans than ever before can “Get into the Act.” Older Americans Month offers an opportunity to emphasize how older adults can access the home- and community-based services they need to live independently in their communities. It is also an occasion to highlight how older adults are engaging with and making a difference in those communities. All Americans should work together to promote healthy aging, to increase community involvement for older adults, and to tackle important issues concerning seniors in American.

Source: U.S. Administration for Community Living (www.acl.gov)