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Bone Matters with Dr. Marla Shapiro

This article is the first in a series, exclusive to Health and Discussing issues that are important to you, a postmenopausal woman concerned about her bone health, Dr. Marla Shapiro will draw upon her expertise and that of other expert colleagues to keep you up-to-date on the latest thinking in osteoporosis.

Osteoporosis and the Sandwich Generation
What is the "sandwich generation"?

"Sandwich generation" is the term often given to those caught between the generations. People just like me find themselves focusing on either end of the spectrum of caring. On the one hand, we are balancing the often difficult demands of raising our own children, and on the other hand, caring for aging parents or relatives. Dealing with these demands can make life interesting but also very stressful.

According to a 2002 Canadian General Social Survey, almost 30% of those between the ages of 45 and 64 with unmarried children under 25 are caring for a senior (approx. 712,000 people). That is indeed a large number.

...almost 30% of those between the ages of 45 and 64 with unmarried children under 25 are caring for a senior.

It is very likely that the number of people making up the "sandwich generation" will continue to grow at a quick pace. Projections show that, by the year 2056, the proportion of Canadians over the age of 65 will more than double to over 1 in 4 and the proportion of people 80 and over will triple to about 1 in 10, according to figures taken from the 2007 General Social Survey (GSS) on Family, Social Support and Retirement. We look at this aging demographic and some liken it to an advancing tsunami of the aged. There is no question that as a result of this, the shift in diseases we see will reflect this growth in the older population.

Osteoporosis – a family affair?

According to Osteoporosis Canada, as many as 2 million Canadians suffer from osteoporosis. Women seem to be affected by it more than men. One in four women over the age of 50 has osteoporosis while it affects only 1 in 8 men of the same age here in Canada.

Osteoporosis has certain characteristics. These include low bone mass and deterioration of bone tissue, which can make bones weaker and more fragile, thereby increasing one's risk of experiencing a bone break or fracture.

Fractures are the most important complication of osteoporosis that I see in the office and can have a devastating impact. Osteoporotic fractures can lead to deformity that progresses over time. One such deformity is a pronounced forward curve in the upper spine or hump-back appearance (also known as kyphosis). Osteoporotic fractures can also negatively impact one's self esteem and can make it difficult for one to get around independently. They can even make simple activities of daily life hard to do without help from others.

A 50-year-old woman has a 40% chance of developing hip, vertebral or wrist fractures during her lifetime. Simply put, that means out of 10 women, 4 will suffer some kind of broken bone. Over 80% of fractures that occur in people 60 and over are believed to be osteoporosis-related.

What is particularly troubling about osteoporosis is the fact that it often occurs without our knowing. It is sometimes referred to as the "silent thief" because the bone loss occurs without symptoms. It may not be until a fracture occurs that we even realize anything is wrong. And that is too late from my point of view. While we have treatments, which I will discuss, prevention is the primary goal.

...80% of fractures that occur in people 60 and over are believed to be osteoporosis-related."

One of the major risk factors for osteoporosis is having a family history of osteoporotic fracture (especially if your mother has suffered a hip fracture).

As part of the "sandwich generation", you may already be dealing with the effects of osteoporosis, first hand. You may be concerned, and rightly so, about your risk and perhaps even the risk for your daughter developing osteoporosis as she gets older. I often tell my patients that what we did while we were young can have an impact on how strong and dense our bones are later in life. In particular, the amount of dietary calcium we get when we are young influences the development of bones and their density. That is because we build our bones to their maximal strength during the growing years.

Osteoporosis is not a normal part of aging nor is it a certainty if you have a family history of osteoporotic fractures. There are things you can do to help yourself and your daughter and your son now. Furthermore, if you are caring for a parent or relative with osteoporosis, there are treatments available.

The best thing you can do is educate yourself and speak to your doctor.

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