Posts Tagged ‘Fracture Risk’
Can you still do all the physical activities you want to do? Activities of Daily Living (ADLs) are the key to enjoying your life, especially as we grow older. At ISCD last month we learned some tricks to maintain our ability to do everything we need to do for a full life.
As we age, we lose muscle mass (Sarcopenia). Loss of muscle mass leads to even faster loss of muscle strength (Dynopenia). Loss of muscle strength is a strong predictor of Fall Risk and Fracture Risk. Bummer!
Get your butt off the couch! You should be able to stand, then sit, then stand again for 5 cycles in 15 seconds. If you cannot, you are in danger of losing your ability to live independently. Loss of the knee extension strength needed to stand, even once, predicts mortality. Huge bummer!
There is no medication for loss of strength. We do have natural activities: Balance exercises (standing on one leg); Aerobic exercises (walking for distance, not speed); Progressive strength exercises (sit to stand to partial squat to stand….). Enough extra Vitamin D3 to get your level above 40ng/ml helps your muscles. And you MUST get enough Protein in your diet.
Jay Ginther, MD
Spring is here. The birds are singing. Soon flowers will be blooming. All the world is coming to life. And more hips will be breaking.
32% of all hip fractures (nearly 1/3) occur in Spring! Nearly 1/3 of hip fractures over 70 are in men. And nearly 1/3 of those men die within months from medical complications initiated by their hip fractures. Dangerous!
What can we do to avoid those fractures? Decrease Fracture Risk! How? Do the following:
It is March; this is Iowa; almost 90% of persons not on major doses of Vitamin D3 are low. (By late September that falls to less than 60% that are low.) Remember that if you have a low Vitamin D level, you cannot absorb enough of the Calcium you consume in food and/or supplements. Take extra Vitamin D3.
Remember that while Calcium Citrate is always absorbable, Calcium Carbonate often is not. Remember that you need enough Magnesium to absorb Calcium. A Senior Multiple Vitamins & Minerals has enough Magnesium for those of us over age 50, and lots of other good stuff too.
Protein is a big deal, especially over age 60, when our protein needs actually increase. 80% of bone and 90% of muscle are protein. Regular exercises, including Balance Exercises, are necessary to Prevent Falls.
Take Control Naturally with proper nutrition and exercises.
Jay Ginther, MD
Driving to Chicago in February was cold and snowing. But it was hot indoors at the ISCD (International Society for Clinical Densitometry) Annual Meeting and Position Development Conference (PDC).
While no new technologies were introduced, the PDC evaluated the scientific studies of several recent innovations. Most are best done in research centers. One recent innovation could make it to clinical centers. Trabecular Bone Score (TBS) is a software addition to DXA that adds information about the quality of bone by re-analyzing the L1, L2, L3 vertebrae.
We have discussed how adding Vertebral Fracture Assessment (VFA) to a DXA Bone Mineral Density (BMD) improves Fracture Risk calculation. TBS has the same potential. The main issues blocking TBS are software cost, added time, and the fact that all insurances (including Medicare) currently do not pay for it.
We also attended presentations about patient treatment issues. Fracture Prevention is much more than just checking a T-score with DXA. National experts shared their knowledge of medical issues that can strongly influence Bone Health and Fracture Risk. More about these sessions next time.
You can Take Control of your Future with action to decrease your fracture risk.
Jay Ginther, MD
DXA is very good at determining Bone Mineral Density (BMD), provided you look at the images and over-read the computer. DXA alone is less good at predicting Fracture Risk. But, Fractures are what we want to avoid.
At the International Society for Clinical Densitometry (ISCD) meeting this week, we will discuss the other modalities, which supplement DXA to obtain greater accuracy. Vertebral Fracture Assessment (VFA) helps evaluate bone quality. FRAX was specifically designed to predict Fracture Risk. QCT (Quantitative Computerized Tomography) has been added in recent years as an alternative to DXA.
ISCD will discuss adding TBS (Trabecular Bone Score), Hip Structural Analysis, Hip Axis Length, and uses of Central CT. We are constantly pushing toward our goal – Prevent Fractures.
Preventing Fractures is not just DXA. Get a Complete Bone Health Evaluation.
Take Control of your future. Check your bone health.
Jay Ginther, MD