Active Life Wellness: A Simple Business Model

Thursday, February 5, 2009

A Simple Business Model

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Articles on Bone Health

NATIONAL OSTEOPOROSIS FOUNDATION SURVEY REVEALS LOW AWARENESS OF BONE HEALTH AND RISK OF OSTEOPOROSIS

Despite Growing Numbers of Americans Living with or at Risk for Osteoporosis, Conversations about Bone Health and Testing for Osteoporosis is Lacking

Washington, DC (May 22, 2008) – The National Osteoporosis Foundation (NOF) today announced results of a nationwide survey that reveals a concerning low awareness of bone health and risk for osteoporosis in American men and women age 45 and older, as well as a lack of conversations regarding bone health between patients in this age group and their health professionals.

While 55 percent of people over the age of 50 are living with or at risk for osteoporosis, the study reveals that 40 percent of women and 60 percent of men age 45 and older have little or no concern about their bone health. The study also reveals that most Americans 45 and older are concerned about the impact a broken bone would have on daily activities and their independence to live how they choose, however, almost 80 percent of them do not believe osteoporosis as a risk factor in broken bones.

This failure to link osteoporosis with broken bones as we age is particularly concerning when one in two women and one in four men older than 50 is estimated to break a bone due to osteoporosis in their remaining lifetime. In fact, a woman’s risk of a hip fracture is equal to her combined risk of breast, uterine and ovarian cancer. Fracture is the medical condition name commonly used to describe a broken bone. A fracture is a break, however, almost half of Americans age 45+ are not aware that these are the same.

According to the study, six of ten women and nine of ten men have not yet had a discussion about the risk of breaking a bone with their healthcare provider. A staggering four in ten women in this age group have not had a bone density test, and for men this number is nearly twice as high. Americans report they didn’t think to ask about a bone density scan or were waiting for their health professional to bring it up. Both women and men are unlikely to have a bone density test in the coming year.

“We strongly urge patients to become aware of the risks and causes of broken bones as they get older,” said Dr. Felicia Cosman, M.D., clinical director of the National Osteoporosis Foundation. “It is clear that discussions between health professionals and patients about bone health are not commonplace. NOF is working to advance the process of evaluation, diagnosis and treatment of osteoporosis through developments such as our new Clinician’s Guide to Prevention and Treatment of Osteoporosis, however, patients need to take charge of their health and bring up the topic with their health professionals rather than relying on them to bring it up first.”

The National Osteoporosis Foundation recently released its new Clinician’s Guide to Prevention and Treatment of Osteoporosis representing a major breakthrough in the way healthcare providers evaluate and treat people with osteoporosis or low bone mass. These developments provide a markedly improved method to assure that people with the highest risk of fracture get treated and that lower risk people are put on a prevention plan that is right for them. The guide incorporates the World Health Organization’s (WHO) recently released algorithm on absolute fracture risk called FRAX® which estimates the likelihood of a person to break a bone due to low bone mass or osteoporosis over a period of ten years.

The pre-press draft of the guide is now available for download on the NOF Web site (www.nof.org) and has been widely viewed by NOF’s network of health professionals. The guide will be printed and distributed to thousands of health professionals across the country within the next several months.

The survey revealed that bone density testing is covered by most health insurance plans. Patients should ask their health insurance if they are covered and to speak with their health professional about their bone health. NOF recommends all women age 65 and older and men age 70 and older receive a bone mineral density test. Additionally, depending on an individual’s risk, postmenopausal women and men age 50 - 70, should be tested as well any adult who has suffered a fracture.

This survey was conducted by the Roper Public Affairs and Media group among a national random digit dialing (RDD) probability sample of 661 Americans age 45 and above. The survey was conducted April 11 – 13, 2008 and the margin of error is +/- 4 percentage points.

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Established in 1984, the National Osteoporosis Foundation is the nation’s leading voluntary health organization solely dedicated to osteoporosis and bone health. Our mission is to prevent osteoporosis, to promote lifelong bone health, to help improve the lives of those affected by osteoporosis and related fractures, and to find a cure. For more information on osteoporosis and bone health, contact NOF online at www.nof.org or by telephone (800) 223-9994.

National Osteoporosis Foundation (NOF) Releases Survey Showing Few Women Believe They Are at Risk for Osteoporosis, Despite Staggering Prevalence Numbers

NOF Urges Women to Talk to Their Doctors About Their Bones

April 6, 2004 (Washington, D.C) – Even though the majority of women aged 45 and older have at least two risk factors for osteoporosis, only 15 percent of those women not diagnosed by a doctor believe they are at risk for the disease, according to a new survey conducted by Roper Public Affairs and Media on behalf of the National Osteoporosis Foundation (NOF).

NOF prevalence estimates show the number of women age 50 and older who have osteoporosis or are at risk for developing the disease will increase from almost 30 million in 2002 to over 35 million in 2010. Osteoporosis, or porous bone, is a devastating disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and increased susceptibility to fractures, especially of the hip, spine and wrist, although any bone can be affected.

The survey tested women’s knowledge of osteoporosis, the actions they take to keep bones healthy, their overall concerns about aging, the information sources they rely on and their perception of personal risk of developing osteoporosis. The survey was funded as part of a grant that NOF received from the U.S. Department of Health and Human Services, Administration on Aging.

“Women need to know their health risk for osteoporosis and what they can do to prevent the disease,” said Josefina G. Carbonell, Assistant Secretary for Aging. “While we know that effective prevention, diagnosis and treatment strategies exists for osteoporosis, many women have not taken action. At AoA, we want to reverse this trend. We want women empowered on this issue and we want them taking action to prevent this debilitating disease,” Carbonell added.

Women Express Little Concern About Risk of Bone Loss

“Women do not perceive themselves to be personally at risk for osteoporosis, even though one in two women aged 50 and older will experience an osteoporosis related fracture in their lifetime. Women age 45 and older may be aware of osteoporosis, but do not relate that awareness to their own risk,” said Judith Cranford, Executive Director, NOF.

“We need to bridge the gap between perception and reality that is underscored by this survey, and encourage women to assess their personal risk and take the preventative steps that can help them to protect their bones including speaking to their healthcare professional,” said Bess Dawson-Hughes, MD, President, NOF.

When asked to identify their level of concern about a range of common health issues – only 62 percent – said they were “very or somewhat concerned” about their risk of bone loss.

The Top Risk Factor

The top risk factor cited for osteoporosis among survey respondents was having normal or early menopause. Other risk factors – increasing the likelihood for developing osteoporosis – were being small boned or thin, having a family history of osteoporosis, a history of smoking, leading a sedentary or inactive lifestyle and currently smoking cigarettes.

Women Are Not Talking With Their Doctor

Many women, more than four out of ten, are not talking to their doctor about osteoporosis or keeping their bones healthy. Over half – 54 percent – of the women age 45 to 54 are not doing so due to a lack of concern about the issue or a belief that their doctor would bring it up “if it were important.”

Recognizing the Importance of Early Diagnosis and Testing

Regardless of age, the women surveyed are aware that early diagnosis and having a bone
density test are important. But, nearly four in ten have not had a bone density test. Bone density tests, which measure the amount of bone in different parts of the skeleton and can predict risk of future fracture, become more common when women reach 55 years of age.

Osteoporosis The Toronto Star January 29,2009

Early Testing helps identify “ the blind thief”

Woman uses diet,physio and hormone injections to cope with bone disease

Paul Dalby

Special to the editor

Christine Thomas navigates the icy sidewalk outside her home with a mixture of extreme

caution and absolute dread. Her daughter reaches out to steady her as she gingerly steps forward, the clamp-on-treads on her boots trying to find a safe purchase

The daily ritual would not be that unusual for a senior, but Christine Thomas is only 49 and the daughter steadying her passage is a 7 year old youngster.

This is the stark reality of life for a woman diagnosed with osteoporosis after she slipped and feel fracturing her spine in 5 places.

I'm super cautious around ice because you never want a fracture againbut the fear is always looming over your head.”Thomas says.

Once a high-flying mediator with Revenue Canada and now permanently retired on medical grounds, Thomas is one of 1.4 million Canadians suffering from osteoporosis.

Once considered an elderly person's disease, osteoporosis strikes one in four women over the age

of 50 years.

The cost of treating the disease and the fractures it causes is estimated to be $1.9 billion per year in Canada.

Osteoporosis is characterized by low bone mass and deterioration of bone tissue.It leads to bone fragility and risk of fractured bones, mostly in the hips,spine and wrist.

For Thomas who lives in Ottawa with husband Gerry Derouin and daughter Chanel,the arrival of osteoporosis came early- right after the birth of her baby in 2002.

During the last eight weeks of her difficult pregnancy, she had been confined to a hospital bed and placed on blood thinners.

Neither Thomas nor her doctors realized that she was probably in the early stages of osteoprosis at that time, so the bed rest and the blood thinners proved a devastating combination, robbing her of her bone density, which may not have been good going into pregnancy.

It didn't take long for Thomas to discover the extent of her condition. Soon after arriving home with baby Chanel, she suffered a minor fall and found herself in excruciating pain.

Diagnosis and a battery of tests revealed she had five spinal fractures,the direct result of severe osteoporosis.

“The pain is just so awful, I had to go on antidepessants. But I told myself if I am ever going to get out of this,to survive as a mother and a spouse, I've got to do something to go forward” she recalls.

Thomas was determined not to retreat into herself, but she had to balance her own precarious health with the growing demands of a highly energetic daughter.

“For someone like me who has had spinal fractures, you can't bend forward even to tie your shoelaces” she says.” Since she was young Chanel has learned to crawl up in my lap because I don't pick her up. She will just point to my lap when she wants a hug.”

Thomas says the little girl has adapted well to her mother's condition.

“When I'm around the school she will always tell her friends that she has to go back and help her Mom,”she says.

The other day in the car ,she asked me”Mommy, is your back ever going to get better?”And it was

hard for me to explain that the fractures that I have have altered the shape of my spine

forever,”Thomas says.” I told her that it will never go back to normal .Ever.”

But this certain knowledge encourages Thomas to be as active as possible and play a full role in her daughter's life. A strict regimen of careful diet and exercise, daily hormone injections, sessions with a physiotherapist and a personal trainer all help to keep her mobile.

“I'm better than I was but I don't golf anymore, I don't skate anymore, and I don't ski anymore” she says. It's up to her husband to accompany Chanel on all high energy activities.

Thomas is pragmatic about her condition and the slow steady progress that she has made to better mobility.

“Just being able to get out of bed and not use a walker or a cane or a back brace and being out of pain is a blessing” she says.

Armed with a good education but no career to apply it to, she has channeled her skills into becoming a champion for getting the message out about osteoporosis to other women. She is the chair of the Ottawa chapter of Osteoporosis Canada, a national charitable organization for public education and has been honored for her efforts.

“I have to say that this is very rewarding because I gainr=ed knowledge on my treatment and then in turn I share my story so that it doesn't happen to other people.” Thomas says.

Her story is a powerful illustration of the need for early testing and early detection of osteoporosis.

The problem with osteoporosis is that it is called the “Silent thief” because you slowly lose bone density without knowing it”explains Dr. Sophie Jamal, director of the multidisciplinary osteoporosis program at Women's College Hospital in Toronto and a scientific researcher.

“ The next thing you know, you have a fracture, and what we do want to prevent above all else are fractures because they can lead to disablity and can actually increase your risk of dying.”

The problem. says Jamal, is that osteoporosis is under-recognized and undertreated.

Bone Density Scan Key to Diagnosis

The most important strategy doctors use to diagnose the onset of osteoporosis is a bone density test.

Bone density machines are now increasingly part of every hospital's arsenal. But statistics prove many women still do not ask their doctors for the test.

“We have data that there is a whole group of patients who are seen in fracture clinics in Ontario with what sounds like osteoporotic fractures (but) are not being tested or being treated for osteoporosis.”says Dr. Sophie Jamal,of Women's College Hospital.

She says the one time test is quick and painless- 15-20 minutes with very low -level radiation.

It involves lying on a table while a small x-ray detector scans the spine, one hip or both. From the scan, a 10 year Absolute Fracture Risk known as a T-score can be detected, which takes into account such factors as age and gender.

“Bone density tests can tell us how much bone you have, the bone quantity, and that is a good indicator of your fracture risk, Jamal says.

She recommends that all women over the age of 50 should get the test done as well as any woman over 40 who has suffered a recent fracture.

The bone mineral density (BMD) tests accurately measure the density of your bones in the spine, hip,total body and wrist and calculate their density of minerals (such as calcium).

The MBD test can tell whether you have osteoporosis or how likely you are to develop it, and can help you and your doctor make decisions that may help prevent fractured or further bone loss.

-Paul Dalby

Active Life Wellness

Thursday, February 5, 2009

A Simple Business Model

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