The trend translates into spiraling health-care costs, with the price tag related to osteoporotic fractures among all Hispanics expected to soar from $754 million in 2005 to $2 billion per year in 2025, according to the National Osteoporosis Foundation.

Treatment and prevention
Lucia Tamayo, 65, a bilingual secretary who emigrated from her native Colombia to Rhode Island 34 years ago, found out she had osteoporosis at age 50, when her daughter suggested she get a checkup.

After being diagnosed, Tamayo didn’t let osteoporosis take control of her life. It’s important “not to feel as though the world has come to an end,” says Tamayo, who takes advantage of patient support groups and keeps up with the latest medical updates by attending conferences on osteoporosis. Instead, she says, stay optimistic and do all that is possible to strengthen your bones.

But you needn’t wait for a fracture or diagnosis, doctors say. Start a regime of diet, weight-bearing exercise, and testing to identify your risk, prevent deterioration, and slow the progression.

Prevention Tips Diet: Drink plenty of milk and lactose products, which contain calcium. Eat sardines, salmon, and mackerel, which are rich in calcium as well as vitamin D. Limit caffeine, since it causes the body to excrete calcium faster. Ask your doctor about eating soy, which supplies a good amount of calcium as well as plant estrogen to maintain bone density. Supplements: Ask your doctor about calcium supplements that contain vitamin D and vitamin K. Depending on your age and risk factors, daily dosage can be 1,000 to 1,500 mg. Exercise: Regular weight-bearing exercise helps stop bone loss and builds strong bones. Try walking, running, weight lifting, tennis, and volleyball. Exercise that keeps weight on your bones or forces you to jump up and down are best. Exams: Ask your doctor to measure your height every year—a loss of one or two inches is an early sign of osteoporosis—and test your bones regularly. Talk to your doctor about any existing conditions, such as kidney disorders and cancers, that can threaten your bone density. Lifestyle: Quit smoking—smokers have up to 10 percent lower bone density than non-smokers, and avoid excessive alcohol—which prevents your body from absorbing calcium properly. —National Osteoporosis Foundation and National Institute of Arthritis and Muscoloskeletal and Skin Diseases

DXA (dual energy X-ray absorptiometry) and BMD (bone mineral density) exams use X-rays to measure bone mineral density in hips and spines. The exams are painless and may be covered by insurance and Medicare. Dr. Cosman recommends that women start taking regular bone density tests by age 65, and that men be checked routinely by the age of 70. Younger individuals, she says, should review their susceptibility to osteoporosis with their doctors. “Look at all the risk factors—such as medications that may cause risk to the bones—and [assess] the environmental safety in the home for falling risks.”

In addition, doctors stress the importance of getting adequate calcium and vitamin D and avoiding excess alcohol—more than two drinks a day. Cosman recommends eating three servings a day of milk, yogurt, cheese, and other foods containing high amounts of calcium. She lists fortified cereal, oranges, salmon, mackerel, and grapefruit juice as good sources of vitamin D. Many doctors also recommend calcium supplements with vitamins D and K.

“It’s a disease that really begins in youth,” says Cosman, which is why nutrition and lifestyle are so important for its prevention. “The genes are there, [and] the lifestyle choices that we make are already acting on bone strength during youth.”

Doctors may prescribe bisphosphonates, powerful drugs that reduce the incidence of fractures by altering bone physiology, to treat or prevent the progression of brittle bones. These can be taken once a day, week, or month depending on the dosage and the patient’s needs. Possible side effects include muscle aches, constipation, abdominal pain, nausea, and heartburn.

Fernandes, who also serves as president of the AYR Consulting Group medical services provider, reacted badly to the first two bisphosphonates her physician prescribed. “The first caused total body urticardia—my whole body starting itching,” says Fernandes, and the second made her upper eyelids swell. Happily, the third proved effective with no negative side effects.

Check Your Medicare Benefits Medicare may cover the cost of bone density exams every two years for certain patients, including women with estrogen deficiency and individuals with vertebral abnormalities or those receiving long-term steroid treatment. For more information on Medicare-covered bone scans, the U.S. Department of Health & Human Services offers a downloadable brochure, “Bone Mass Measurements.”

“These medications are safe if they're given to the patients who need them," Cosman says. "People should talk to their doctors about their prescriptions and [whether] the medication’s results on improving your bone health outweigh the side effects you may experience.”

To allow her to maintain an active lifestyle, Fernandes and her physician agreed on a plan of care. “We decided that I should take medication, walk regularly, and begin a regimen of physical therapy regularly to strengthen my muscular system,” she says.

Tamayo has also developed a new lifestyle to strengthen her bones; she takes her medication, watches out for falls, eats more fruits and vegetables and foods containing calcium, and exercises daily. And, she says, indulging as much as possible in her favorite exercise: “I dance at family get-togethers and holiday celebrations.”
 
Bottom line: It’s never too late to improve your bone health, even if you already have osteoporosis. Taking care of your bones will help keep you active into your later years. And that’s cause for celebration. 

Save Yourself a Trip Every day, everywhere, many things can trip us up. Annually, nearly one in three Americans over age 65 falls. This can result in head and brain injuries and bone fractures, and for adults 65-plus falls are the number one cause of injury deaths, nonfatal injuries, and hospital admissions for trauma, according to the Centers for Disease Control and Prevention. Among Latinos 50-plus, nearly half of women and nearly one fifth of men suffer from low bone mass, which means bones are more likely to break with a fall. "Exercise is the best thing, preventing you from falling by keeping you strong, flexible, and able to balance. Walk, dance, play with your grandkids—it's all exercise!" says AARP President Jennie Chin Hansen.—Fresia Rodríguez Cadavid The CDC also recommends these steps to prevent a fall: Ask your doctor or pharmacist to evaluate your prescription and over-the-counter medications to lower side effects and interactions that may lead to imbalance or dizziness. Have your eyes and hearing checked once a year. Reduce dangers in your home that can cause falls. This includes keeping floors free of clutter, improving lighting, and using a rubber bathmat. Have an occupational therapist inspect your home and recommend ways to eliminate environmental hazards and unsafe behaviors.