Dr. Maninder Ahuja discusses new paradigms in osteoporosis diagnosis. Key points include:
- Osteoporosis is underdiagnosed and the number of aging women is increasing worldwide. Early diagnosis and prevention are important.
- DEXA scan is the gold standard for diagnosis but FRAX model also calculates fracture risk from additional factors.
- Lifestyle modifications, calcium, vitamin D, and treating underlying causes can help prevent osteoporosis and fractures.
2. DR.MANINDER AHUJA CHAIRPERSON GERIATRIC GYNE.COMMITTE FOGSI TO DIAGNOSE OSTEOPOROSIS WE HAVE ALWAYS TO KEEP IT IN MIND WHEN TREATING AGING WOMEN ! Dr.ManinderAhuja chairperson geriatric gynecology committe FOGSI 05/01/10
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4. NUMBER OF AGING WOMEN IS INCREASING Dr.ManinderAhuja chairperson geriatric gynecology committe FOGSI 05/01/10 1990 2030 World wise population 470million 1.2 billion Developing countries 40% 24% Developed countries 60% 76%
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7. Osteoporotic Fracture 1,200,000 Heart Attack 513,000 Strokes 228,000 Breast Cancer 1,84,000 1 million > 2.0 x > 4.4 x > 5.5 x OSTEOPOROSIS IN WOMEN : CONCERN Dr.ManinderAhuja chairperson geriatric gynecology committe FOGSI 05/01/10
8. Osteoporosis – the silent disease Under diagnosed and most common 35 yrs onwards you lose bone mass at 0.5 to 1% per yr(initial quality Imp) Around menopause loss is upto 4-5 % per year You also lose muscle mass from 35 years onwards vitamin D receptor, estrogen receptor, transforming growth factor, interleukin-6, interleukin-1 receptor 2, type I collagen genes, and collagenases are for genetic causes Dr.ManinderAhuja chairperson geriatric gynecology committe FOGSI 05/01/10
9. Sarcopenia and osteoporosis go hand in hand Dr.ManinderAhuja chairperson geriatric gynecology committe FOGSI Beginning in the fourth decade of life, adults lose 3 % to 5% of muscle mass per decade,rate of decline increases to 1% to 2% per year after age 50 years( RED ALERT FAT) N sarcopenia 05/01/10
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14. Other methods of Diagnosis Dr.ManinderAhuja chairperson geriatric gynecology committe FOGSI 05/01/10
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25. 10-year Probability of Fracture in Women by Age and FN T-Score- ”age and BMD are independent predictors” Dr.ManinderAhuja chairperson geriatric gynecology committe FOGSI 05/01/10
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28. Risk should be >3%for hip#&>20% for all major # Dr.ManinderAhuja chairperson geriatric gynecology committe FOGSI 05/01/10
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32. Vit D Def & Risk Of Falls Dr.ManinderAhuja chairperson geriatric gynecology committe FOGSI 05/01/10
Incidence od osteoporotic fractures is more than all combined incidence of breast cancer, stroke and heart attack.it is more then 5.5 times incidence of breast cancer, 4.4 times incidence of stroke and more than twice the incidence fo heart attack , even then we are neither aware of osteoporosis and nor are taking any measures fot timely diagnosis.
United States National institute of Health consensus conference modifies this definition as follows: “
(Title and text box Appears) The risk factors for osteoporosis are well known. They include being (1 st left -hand bullet Appears) female, (2 nd left -hand bullet Appears) over 50, (3 rd left -hand bullet Appears) having low estrogen, (4 th left -hand bullet Appears) being thin with a body mass index of less than 19 kg/m2, (5 th left -hand bullet Appears) having low bone mass, (6 th left -hand bullet Appears) having a history of fragility fractures in yourself or a family member, (1 st right -hand bullet Appears) having poor nutrition with deficient calcium and vitamin D intake, (2 nd right -hand bullet Appears) smoking, (3 rd right -hand bullet Appears) excessive use of alcohol, (4 th right -hand bullet Appears) having an inactive lifestyle, or (5 th right -hand bullet Appears) having taken steroids or anti-convulsant drugs.1,3
Socio economic Over $17 billion annually in direct medical costs Over 430,000 hospital admissions annually Approximately 2.5 million medical visits each year Over 180,000 annual admissions to nursing homes Potential for lost income due to incapacitation, morbidity, and mortality risks
With the same BMD at different ages risk of fracture is different e.g -1.5 score at age 50 carries a risk of 5.9 but at age 70 this 10 year probability risk increases to 14.6