New Canadian guidelines on preventing osteoporosis stress on the need to identify fractures caused by weakened bones. The approach marks a paradigm shift away from low bone mineral density, it has been pointed out.
Despite the high prevalence of fragility fractures, current data indicate that they are not appropriately assessed or treated, Osteoporosis Canada has regretted in its 2010 Clinical Practice Guidelines for the Diagnosis and Management of Osteoporosis.
Someone who has experienced a fragility fracture is likely to experience another, yet fewer than 20 per cent of women and 10 per cent of men who have sustained fragility fractures receive therapies to prevent their bones from breaking in the future. Fractures can have a devastating impact on a person's quality of life, leading to chronic pain, further illness or even death.
The appropriate identification of those at high fracture risk is essential; Osteoporosis Canada's new guidelines help physicians and patients better identify the risk of fracture, resulting in better fracture prevention and better management of osteoporosis overall, it is hoped.
"There have been many advances in the study of osteoporosis since we launched the last guidelines in 2002," said Dr. Alexandra Papaioannou, lead author and Professor of Medicine, Division of Geriatric Medicine, McMaster University. "We now recognize that BMD is only one of many risk factors for fracture, and so it is important for physicians to take an integrated approach to the assessment of fracture risk and use the new tools available to better manage osteoporosis."
"The new guidelines provide guidance to doctors and the general public on how to prevent fractures and maintain strong bones for life," said Dr. William Leslie, co-lead author, chair of Osteoporosis Canada's Scientific Advisory Council and Professor of Medicine and Radiology at the University of Manitoba"The guidelines introduce tools for physicians and patients, including a new 10-year fracture risk assessment tool that will guide physicians in the comprehensive management of patients at high risk for fracture."
"Osteoporosis Canada is delighted to launch these new guidelines, which provide guidance for patients and physicians alike on how to best manage osteoporosis," said Dr. Famida Jiwa, acting President & CEO, Osteoporosis Canada. "The impact of fragility fractures can be devastating for a patient, which is why all Canadians over the age of 50 who have had a fracture should discuss osteoporosis and fracture risk factors with their doctor."
The guidelines recommend that patients at risk for fracture incorporate changes into their lifestyle to prevent bones from breaking. Regular physical exercise that includes weight-bearing activities along with adequate intake of calcium and vitamin D are important to building bone strength and balance. For some, medication may be needed to prevent fractures.
While osteoporosis often goes unnoticed and without symptoms, common signs of osteoporosis include hip or spinal fractures in the absence of significant trauma to the bone. For many Canadians over the age of 50, a hip fracture due to osteoporosis usually occurs after a fall. A major risk factor for osteoporosis is family history of fragility fractures, and a hunched upper back or loss of height commonly signify possibility of spinal fractures. For those at high risk of fracture, early intervention is key to the prevention of fractures; those who have experienced these symptoms should speak to their doctor, the guidelines stress.