DESPITE IMPROVEMENTS, MOST WOMEN WITH OSTEOPOROSIS REMAIN UNAWARE OF THEIR CONDITION

By Grattan Woodson, MD FACP

For many years, we have had the ability to identify patients at risk for future fractures by testing their bone density.  Placing these patients on drug treatment with any of a variety of FDA approved agents can prevent the patient from suffering severe bone loss. 

Amazingly, despite these advances in prevention, only about one third of the patients at risk for osteoporosis have even had bone density testing and of those who have been tested and found to have bone loss, only half are on treatment.   The at-risk patient is primarily the postmenopausal woman.  Interviews with at-risk patients who had bone density tests reveals that often it was the patient themselves that suggested the doctor order the test.  This makes it likely that most of the proactive patients have already had their tests and suggests that the roughly two thirds of the at-risk women have not been tested are likely to be more passive about this issue. 

Recently, the US Preventive Task Force supported testing all women older than age 65 and women as you as 60 if they had risk factors for the disease.  In my opinion, the patient should have her first test at the time of menopause but certainly no later than her 60^th birthday.  If we can identify women between age 50 and 60 who already have significant bone loss (t-score < -2) before they experience their first fracture, treatment is simple, relative inexpensive, and very satisfactory.  This is especially important now that the routine use of HRT has changed following the publication of the Women’s Health Initiative Estrogen and Progesterone therapy group results last July in Journal of the American Medical Association.   

The Osteoporosis Center of Atlanta is the only Atlanta bone density test facility equipped to provide the patient with a diagnostic imaging of the spine to detect the unsuspected presence of vertebral deformities that indicate osteoporosis is severe.  Two thirds of these vertebral fractures are silent and have not been diagnosed.  The presence of these fractures is as important of a risk factor for future fracture as bone density.