Dr. Steven R. Goldstein MD
The Burden of Osteoporosis, Poor Bone Health, and Fragility Fractures
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Dr Steven R. Goldstein MD is an Osteoporosis Specialist in NYC and
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Menopause Specialist
Menopausal
a leading
in NYC. For more than 25 years he has helped women cope with the symptoms of menopause.
women are also at risk for Osteoporosis, poor bone health and fragility
Dr
office almost
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In
Goldstein’s
all women are cognizant of breast health, have a great fear of breast cancer, and for the most part are attuned to the importance of competent periodic breast imaging… the key to earliest detection.
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The goal is not to have a better DXA at age 82, the goal is to not break a hip at age 82 Bone health IS more than just osteoporosis. Dr Goldstein’s hope is to get these same patients to be just as concerned about their bone health as they are concerned about their breast health. He compiled some statistics which will help you to understand how
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Poor Bone Health
Fragility Fractures Worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every three seconds. I
The Burden of Osteoporosis,
and
Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis Int. 2006;17:1726–1733.
The Burden of Osteoporosis, Poor Bone Health and Fragility Fractures
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It is estimated that osteoporosis effects 200 million women worldwide. Onetenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and, two-thirds of women aged 90 carry this diagnosis. ii ii Kanis, JA, Odén A, McCloskey EV, et al. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporosis Int. 2012;23:2239–2256.
The Burden of Osteoporosis, Poor Bone Health and Fragility Fractures
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It is estimated that osteoporosis effects 200 million women worldwide. Onetenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and, two-thirds of women aged 90 carry this diagnosis. ii ii Kanis, JA, Odén A, McCloskey EV, et al. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporosis Int. 2012;23:2239–2256.
It is estimated that osteoporosis effects 200 million women worldwide. One-tenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and, two-thirds of women aged 90 carry this diagnosis. ii
ii Kanis, JA, Odén A, McCloskey EV, et al. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporosis Int. 2012;23:2239–2256.
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iii iii Adult Official Positions of the ISCD as updated in 2019. www.iscd.org. Last accessed July 2021
Worldwide, one in three women after the age 50 will experience osteoporotic fracture.
The Burden of Osteoporosis, Poor
Health and
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At menopause, the removal of estrogen has much greater effects in women than men of similar age. The female-to-male ratio of osteoporotic fractures is approximately 1.6, such that 80% of forearm fractures, 75% of humerus fractures, 70% of hip fractures, and 58% of spine fractures occur in women. iv
Bone
Fragility Fractures
The Burden of Osteoporosis, Poor Bone Health and Fragility Fractures
A prior fracture is associated with an 86% increased risk of any subsequent fracture. V
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v Kanis JA, Johansson H, Harvey NC, et al. A brief history of FRAX. Arch Osteoporos. 2018;13(1):118
.
vi
Fragility fractures are a leading cause of chronic disease morbidity. For instance, in Europe, fragility fractures are the fourth leading cause, after ischemic heart disease, dementia, and lung cancer; however, they surpass chronic obstructive pulmonary disease and ischemic stroke.
vi Kanis JA, Johansson H, Strom O, et al. The National Osteoporosis Guideline Group. Case finding for the management of osteoporosis with FRAX® – assessment and intervention thresholds for the UK. Osteoporos Int. 2008;19:1395–1408.
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After sustaining a hip fracture, 10-20% of formerly communitydwelling patients require long-term nursing care. vii
vii Bone HG, Wagman RG, Brandi ML, et al. 10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension. Lancet
Diabetes Endocrinol. 2017;5:513–523.
Overall,
viii viii Goodpaster BH, Park SW, Harris TB, et al. The loss of skeletal muscle strength, mass, and quality in older adults: The health, aging and body composition study. J Gerontol A Biol Sci Med Sci. 2006;61:1059–1064.
hip fractures cause the most morbidity, and reported mortality rates in up to 20-24% in the first year after a hip fracture.
Loss of function and independence among
survivors is profound, with 40% unable to walk independently, and 60% require assistance a year later. ixWWW.GOLDSTEINMD.COM ix Anker SD, Morley JE, von Haehling S, et al. Welcome to the ICD-10 code for sarcopenia. J
Cachexia Sarcopenia Muscle. 2026;7(5):512–514.
CONTRAST THE ABOVE WITH BREAST CANCER
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•In localized breast cancer where there is no sign that the cancer has spread outside the breast, the 5-year survival in the US is 99%! (American Cancer Society. Survival Rates for Breast Cancer. Available at: https://www.cancer.org/cancer/breast-cancer/understanding-a-br east-cancer-diagnosis/breast-cancer-survival-rates.html ) •Even regional breast cancer, defined as spread outside the breast to nearby structures or lymph nodes, has an 86% fiveyear survival. (American Cancer Society. Survival Rates for Breast Cancer. Available at: https://www.cancer.org/cancer/breast-cancer/understanding-a-br east-cancer-diagnosis/breast-cancer-survival-rates.html )
In developed countries where women have access to periodic competent breast screening by imaging techniques, for many the diagnosis of localized breast cancer and the psychological ramifications may exceed the physical manifestations.
You only need contrast the statistics above vis a vis breast cancer versus the statistics cited about the incidence, morbidity and even mortality associated with osteoporosis and fragility fractures (ESPECIALLY of the hip) to see the importance of bone health and osteoporosis
314 East 34th Street 5th Floor New York, NY 10016 Call: 212.717.5554 Visit us: www.goldsteinmd.com Dr. Steven R. Goldstein MD One of America’s Top Gynecologists