New skeletal age calculator helps fight osteoporosis

Researchers have developed a special calculator that can estimate a person’s risk of bone fracture and premature death.

The skeletal age calculator from the Garvan Institute of Medical Research will enable doctors and health professionals to better identify those at risk of bone fractures and estimate how fractures will affect life expectancy.

“A fracture shortens life expectancy, even more so in men than in women,” says Professor Tuan Nguyen, head of the genetic epidemiology of osteoporosis lab at Garvan and senior author of the study published in eLife. “But there is a lot of complacency in the community when it comes to bone health – only 20 per cent of those with fragility fractures are taking approved treatments for osteoporosis, which could significantly reduce their risk of further fractures.

“We hope that calculating a person’s skeletal age, which may be much higher than their actual age, will identify those who are at higher risk of fractures and encourage them to speak to their doctor about how to better manage their condition.”

The new model defines skeletal age according to their risk factors for fracture.

“Using this definition, we, for instance, estimated that a typical 70-year-old man who had sustained a fracture had a skeletal age of 75 years,” said Prof. Nguyen. “But when the man had a second fracture his skeletal age rose to 87 years. This means the individual now has the same fracture risk profile as an 87-year-old man who has a healthy risk profile.”

Read more: Broken bones increase risk of death

The American Academy of Orthopaedic Surgeons says bone health is important “at every stage of life”.

“The skeleton is our body’s storage bank for calcium – a mineral that is necessary for our bodies to function. Calcium is especially important as a building block of bone tissue.

“We must get calcium from the foods we eat. If we do not have enough calcium in our diets to keep our bodies functioning, calcium is removed from where it is stored in our bones. Over time, this causes our bones to grow weaker.”

The result can be osteoporosis, where bones are very fragile and likely to break, seriously limiting a person’s mobility and independence.

Osteoporosis is estimated to affect more than 900,000 Australians. The cost of osteoporosis and fracture in Australia is $3.4 billion annually.

From age 50, bone fractures affect one in two women and one in three men in Australia.

With each fracture, the risk of future fracture increases twofold. Pre-existing fractures increase the risk of premature death by about 50 per cent in both men and women. One in three adults over 50 dies within 12 months of sustaining a hip fracture.

Read more: What you need to know about bone health

The Garvan team used data from the Dubbo Osteoporosis Epidemiology Study, which began in 1989, the world’s longest-running large-scale study of osteoporosis.

It considered an individual’s age, bone density, history of previous fractures and other health conditions to calculate a personalised estimate of ‘skeletal age’.

“The key message of this study is that it’s never too early to think about your bone health,” says Prof. Nguyen. “Do not wait until a fracture has occurred to take preventive action. If your skeletal age is higher than your actual age, you should seek medical advice on how to manage the higher risk.”

Fractures shorten life expectancy more in men than women, despite women losing more bone density during menopause. But Prof. Nguyen says only 20 per cent of people with fragility fractures take approved treatments for osteoporosis, which could significantly reduce their risk of further fractures.

“We hope that calculating a person’s skeletal age, which may be much higher than their actual age, will identify those who are at higher risk of fractures and encourage them to speak to their doctor about how to better manage their condition.”

After age 40, we slowly begin to lose bone mass. Proper nutrition and regular exercise slows this bone loss.

Read more: Why vitamin D is vital for bone health

The Mayo Clinic’s tips for combatting bone loss:

Calcium. Women up to age 50 and men up to age 70 need 1000 milligrams daily; women over 50 and men over 70 should get 1200 milligrams daily.

Vitamin D. Aim for 600 to 800 international units (IUs) daily.

Exercise. Weight-bearing exercise (i.e., walking) and resistance exercise (i.e., weightlifting) help slow bone loss.

Don’t smoke. Smoking can increase bone loss.

Drink alcohol in moderation. More than a drink a day for women or men over 65, or two drinks for men 65 or under, can speed bone loss.

Remember protein. Protein is one of the building blocks of bone. While most people get plenty of protein in their diets, some do not. Make sure your diet includes lean sources of protein, such as eggs, lentils, white-meat poultry, lean beef, dairy, shrimp and soy.

Maintain an appropriate body weight. Being underweight increases the chance of bone loss and fractures. Excess weight now is known to increase the risk of fractures in your arm and wrist. As such, keeping body weight in check is good for bones just as it is for health in general.

Do you know how to maintain bone health? Do you take any steps to reduce bone loss?

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Written by Will Brodie



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