Preventing Falls Is Key
Preventing falls also is an important aspect of osteoporosis treatment to reduce the likelihood of fracturing a bone in the hip, wrist, spine or other part of the skeleton. Falls can be caused by environmental factors, such as slippery floors and poorly lit rooms, as well as by impaired vision and/or balance, chronic diseases that impair mental or physical functioning, and certain medications, such as sedatives and antidepressants. It is important to be aware of any physical changes that may affect your balance or gait. Discuss any changes or concerns with your health care professional.
Consider making some of these changes to help eliminate environmental factors that could lead to falls:
- Indoors: Keep floor surfaces smooth but not slippery and clear of clutter; wear supportive, low-healed shoes even at home; avoid walking in socks, stockings or slippers; be sure stairwells are well lit and that stairs have handrails on both sides; install grab bars on bathroom walls near tub, shower and toilet; and use a rubber bath mat in the shower or tub.
- Outdoors: Use a cane or walker for added stability; wear rubber-soled shoes for traction; walk on grass when sidewalks are slippery; use caution on highly polished floors that are slick when wet. Use plastic or carpet runners when possible. Some older women at high risk of falls and hip fracture might want to consider hip protectors. These devices are thin shields that can be incorporated into underwear.
The American Geriatrics Society (AGS) recently released clinical practice guidelines to assist health care providers in assessing the risk of falls in older individuals and provide management strategies for reducing fall risk. The recommendations appeared in the May 2001 issue of the Journal of the American Geriatrics Society. The Society has also developed a companion consumer guide that shares tips on reducing the risk of falls. For more information on the Guidelines for the Prevention of Falls in Older Persons and the consumer guide, visit the American Geriatrics Society.
Research and New Treatments on the Horizon
In a recent study conducted by scientists at Ohio State University, 35 pre-menopausal women with breast cancer were treated with chemotherapy, and experienced accelerated bone density loss (eight percent). This surprising result was observed after only 12 months of chemotherapy treatment. The results of this study support a role for bone density scans in those women who develop chemotherapy-induced ovarian failure, according to the lead researcher on the study.
Young women who exercise regularly and use birth control pills may not get the boost in bone strength seen in women who exercise and do not use oral contraceptives, according to a study reported in the June 2001 issue of Medicine & Science in Sports & Exercise. According to the lead researcher for this study, oral contraceptives may control blood estrogen levels and prevent the exercise-induced increase (in bone). Other investigators have not yet confirmed this finding.
Research sponsored by the National Institutes of Health have made a number of significant discoveries that are expected to open a number of exciting new osteoporosis-related research areas:
- identification of a gene essential for the formation of bone
- finding that estrogen causes "programmed cell death" in cells that are responsible for degradation of bone (osteoclasts)
- a "time-release" preparation of sodium fluoride is being evaluated as a possible treatment for osteoporosis and fracture reducer — without the significant side effects associated with earlier versions of this controversial agent
- Lasofoxifene is a newer, potent selective estrogen receptor modulator (SERM) currently undergoing clinical trials in postmenopausal women. Similar to raloxifene (the only SERM with FDA approval for postmenopausal osteoporosis), lasofoxifene does not appear to stimulate uterine tissue, a negative effect associated with other SERMs, such as tamoxifen. The drug is presently in large, multi-center trials and may be approved sometime in the next several years.
- A once yearly, 15-minute infusion of a drug called zoledranate is currently being tested in large, multi-center studies for its efficacy in treating osteoporosis. This drug could be approved within the next several years.
Copyright 2003 National Women's Health Resource Center Inc. (NWHRC).