Osteoporosis Risk Profile            
Check the box for each statement that is true          
                     
Female              
Caucasian, East Indian or Oriental        
Ancestors mainly from Northern Europe, the British Isles, India, China, or Japan
Small build (size 8 dress or less; man's jacket size 38 or less)  
Have (or had) light hair, a fair complexion, or freckles    
Consume fewer than 2 milk products per day      
Exercise less than one-half hour per day or less than 5 miles per week of brisk walking
Drink five or more cups of coffee, tea, or soda daily    
Drink three or more alcoholic beverages daily      
Smoke two or more packs of cigarettes per week      
Postmenopausal            
Menopause before age 40          
Medical history of epilepsy, rheumatoid arthritis, liver disease, juvenile diabetes, or thyroid problems
History of osteoporosis in your family        
Diagnosed with moderate to severe scoliosis      
breastfed one or more babies            
Fracture of wrist, hip, or spine after age 45      
Treated with corticosteroids for a year or more      
Premenopausal but menstruation stopped for a year or more and resumed  
  Points                
                     
  8 points or less: MILD RISK          
  9 to 16 points: MODERATE RISK          
  17 points or more: HIGH RISK          
                     
  Other Risk Factors:            
  Increasing age (older than 40 years)          
  Immobilization or inactivity related to chronic disease or injury    
  Poor calcium intake or malabsorption          
  Lactose intolerance              
  Lack of sun exposure              
                     
  Additional Risk Factors in Postmenopausal Women      
  Lack of estrogen replacement therapy          
  Proximal muscle weakness            
  Constant or intermittent lethargy            
  Bone pain                
  Difficulty walking              
  Low back pain              
                     
  Additional Risk Factors In Men          
  Family history of osteoporosis, especially on father's side      
  Advancing age                
  Use of corticosteroids, anabolic steroids, anticonvulsants, or furosemide  
  Weakness                
  Constant or intermittent lethargy            
  Bone pain                
  Difficulty walking              
  Low back pain                
  Early decline in testosterone level          
  History of malignancy              
                     
  American Academy of Orthopaedic Surgeons        
  Patient Information:              
  Bone is a living tissue, comprised mainly of calcium and protein. Healthy bone is always being remodeled, that is, small amounts are being absorbed in your body and small amounts are being replaced. If more bone calcium is absorbed than is replaced, the density or the mass of the bone is reduced. The bone becomes progessively weaker, increasing the risk that it may break.
  Osteoporosis means 'porous bone.' This condition develops when bone is no longer replaced as quickly as it is removed. More than 1.5 million Americans have fractures related to osteoporosis each year. Most people are unaware that they have osteoporosis until a fracture occurs.
  The exact medical cause for osteoporosis is not known, but a number of factors are known to cause osteoporosis: aging, physical inactivity, reduced levels of estrogen, heredity, excessive cortisone or thyroid hormone, smoking, and excessive alcohol intake.
  Although osteoporosis will occur in all persons as they age, the rate of progression and the effects can be modified with proper early diagnosis and treatment.
  During growth and young adulthood, adequate calcium nutrition and vitamin D and regular weight-bearing exercises, such as walking, jogging, and dancing three to four hours a week, build strong bones and are investments in future bone health. Smoking and consuming excessive amounts of alcohol should be avoided because they increase bone loss. As people age, appropriate intake of calcium and vitamin D and regular exercise, as well as avoidance of smoking and excessive alcohol use, are necessary to reduce loss of bone mass. (Recommended amounts of calcium and vitamin D and suggested exercises are available from the Academy.)
  Family doctors working with your orthopaedic surgeon can evaluate whether your bone density has been reduced, and can evaluate the cause for the reduction. Early treatment for osteoporosis is the most effective way to reduce bone loss and prevent fractures. However, treatment programs after a fracture also are of value and may help to prevent future fractures.
  Current treatment methods can reduce bone loss, but there are no proven methods of restoring lost bone. Building bones through adequate calcium intake and exercise when you are young is an investment that will pay off years later with a reduced risk of hip and other fractures. The loss of bone tends to occur most in the spine, lower forearm above the wrist, and upper femur or thigh-the site of hip fractures. Spine fractures, wrist fractures, and hip fractures are common injuries in older persons.
  A gradual loss of bone mass, generally beginning about age 35, is a fact of life for everyone. After growth is complete, women ultimately lose 30 to 50 percent of their bone density, and men lose 20 to 30 percent.
  Women lose bone calcium at an accelerated pace once they go through menopause. Menstrual periods cease because a woman's body produces less estrogen hormone. Estrogen in women is important for the maintenance of bone mass or bone strength.
  Your family doctor or gynecologist may evaluate and recommend a treatment program of estrogen replacement therapy, calcitonin or other medications currently under development. To be most effective, the treatment program should begin at menopause. A measurement of bone density when menopause begins may help a woman decide whether to use estrogen replacement therapy to retard bone loss.
  20 March, 1996              

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