The differences between the experience of osteoporosis between men and women find expression through variances in the bone areas most susceptible to fractures and the peak of risk. In the case of women, there is a higher risk of bone fracture from falls up to 35 years of age. At this point, there is comparable risk of fractures between the sexes. Then after menopause, the risk peaks again for women. Twenty decades, after menopause, the risk of fracture in the forearm, vertebrae and hip bone peaks at 70 years and above.
In the case of men, the risk for bone fractures commence around 75 years and above commencing with the vertebrae, hip then forearm. (Fordham, 2004) In other studies, the highest incidence of fractures for women is between the ages of 50-64, while the highest incidence of fracture occurs in men beyond the age of 85 years (Burge et al. , 2007). This shows differences in the onset and peak of bone fracture risk, which is the primary impact of osteoporosis. In race-based epidemiology, the distribution of fractures differs by race.
In a study of women of different racial backgrounds, the likelihood of developing osteoporosis is 1. 2 for Hispanics, 1. 05 for Asians, . 96 for Blacks, and . 55 for Whites. Measures of bone mineral density is highest for Black women and lowest in Asian women translating into 4. 2 percent of Black women and 10 percent of Asian women experiencing osteoporosis. Surprisingly, both groups have similar low risks of bone fracture. This could be due to the rigorous physical activity of Asian women.
In the other races, 11. 9 percent of Native American women, 9. 8 percent of Hispanic women, and 7. 2 percent of White women have osteoporosis. (Barrett-Connor et al. , 2005) The differences and surprising results point to genetics and non-genetic factors such as diet or nutrition and physical activities as determinants of osteoporosis. Development Stages of Osteoporosis As a degenerative disease, the stages of development of osteoporosis coincides with the natural process of bone mass building and decline that forms part of aging.
In addition, differences in progression based on gender also explain the development stages. Furthermore, genetic and non-genetic factors could affect the progression of osteoporosis. In normal and natural aging, the bone undergoes a renewal cycle through the two-stage process of formation and resorption. In formation, new bone tissues develop from the minerals in the blood. In resorption, there is a breakdown in bone tissue so that the mineral components flow with the blood for recycling or lost in bodily fluids excreted from the body.
Before the age of 35, formation happens faster than resorption. This leads to the growth of bones and increase in bone mass. As the middle age is reached, the speed of formation and resorption evens out. Beyond the age of 35, the speed of resorption gradually increases relative to formation leading to the progressive decline in bone mass. (Meunier, 1998) These stages are shown in Figure 1 below. Figure 1: Bone Mass and Age (Meunier, 1998) Osteoporosis then is the carry-over of these stages, when the rate of resorption becomes greater than the rate of formation.
New bones are hardly formed while bone mass of existing bones decline resulting to smaller and weaker bones. (Meunier, 1998) The likelihood of osteoporosis increases after menopause for women, with the risk of fracture progressing with age and peaking in their 60s to 70s. In the case of men, the likelihood of developing osteoporosis increases with old age but the risk of experiencing fractures begins in their 70s and peaks above 85 years of age. (Fordham, 2004; Burge et al. , 2007) The stage of menopause for women differentiates the progression of osteoporosis for men and women.
Genetic and non-genetic factors affect the stages of osteoporosis usually by slowing or speeding up the process of decline in bone mass to affect the likelihood of developing osteoporosis. Causes of Osteoporosis The factors causing osteoporosis are diverse. First is normal aging, since the gradual decline in bone mass that comes with age could progress to osteoporosis with old age. In this sense, preventing osteoporosis or slowing down its progression involves the accumulation of bone mass before middle age and withdrawal from factors that could speed up its progress.
Second is genetic causes such as polymorphism in a DNA sequence of the COLLA1 gene (Prockop, 1998), although there is yet no common genetic explanation for osteoporosis. Third comprises medical conditions such as limited secretion of gonadal steroids, hormonal imbalance or problems, and calcium and vitamin D deficiency that prematurely affects the bone mass of individuals or prevents individuals from achieving optimal levels of bone density or mass. This then leads to the earlier onset of osteoporosis.
Fourth comprise of secondary causes including drugs such as corticosteroids and contraceptives that decrease bone mass. Fifth are lifestyle and environmental related factors such as poor diet and nutrition, lack of exercise, alcohol and drug intake, and smoking also contribute to osteoporosis. (Meunier, 1998) The impact of these factors on age and gender is shown in Figure 2 below. The impact of genetic and environmental factors occurs prior to middle age.
As such, poor nutrition, smoking, lack of exercise, and gonadal problems prior to the middle age are likely to result in the earlier onset of osteoporosis and speed up its progression for men and women. Beyond middle age, aging sets in and menopause happens for women. Sporadic factors such as alcohol and drug intake, smoking, poor nutrition, and lack of exercise at this point speeds up the progression of osteoporosis, more so and earlier for women. (Meunier, 1998) Preventing or allaying the progression of aging into osteoporosis involves betterment in the environmental or sporadic factors the earliest possible time.