Dr Ananya Mandal, MD
In a new breakthrough, Australian scientists have identified the “remarkable” life-extending properties of an osteoporosis treatment. The research is published in the Journal of Endocrinology and Metabolism on Thursday.
Osteoporosis is a degenerative bone disease and the elderly who are taking a mainline anti-osteoporosis drug have extended their lives by five years on average say researchers. These elderly people were living significantly longer than others. Professor John Eisman from Sydney’s Garvan Institute of Medical Research said, “That was the thing that was really remarkable to us - these people were doing better than, if you like, the average community… Our initial concern was ‘we’ve somehow selected a healthier group ... that’s why they are doing better’, but whatever way we looked at it, it didn’t seem to explain it… Everything about these people imply they would do worse, but they were doing at least as well (as the general population), if not better.”
Prof Eisman, along with lead researcher Associate Professor Jacqueline Center, for this study looked at data collected as part of the long-running Dubbo Osteoporosis Epidemiology Study, which started in 1989. This included data from over 2,000 people, of whom 121 had been taking medication from the bisphosphonates class of drugs for around three years.
Bisphosphonates prevent bone loss by slowing the pace at which the bones naturally renew themselves, a process which is too fast in people with osteoporosis. Even with treatment, osteoporotic patients suffer fewer debilitating bone fractures. But this could not explain the longer life span.
Associate Professor Center said, “While the results seemed surprisingly good, they are borne out by the data – within the limitations of any study – and appear to apply to men as well as women…When we first looked at the figures, we thought that there had to be a fallacy, that we were missing something. One of the most obvious things might be that these are people who seek medical attention, so may be healthier and live longer. So we compared the bisphosphonate group with people taking Vitamin D and calcium or women on hormone therapy.” She added, “The comparison against these other groups of similarly health-aware people simply confirmed that our results were not skewed by that factor….In a group of women with osteoporotic fractures over the age of 75, you would expect 50 percent to die over a period of five years. Among women in that age group who took bisphosphonates, the death rate dropped to 10 percent. Similarly, in a group of younger women, where you would expect 20-25 percent to die over five years, there were no deaths. The data were consistent with about a five year survival advantage for people on bisphosphonates.”
Prof Eisman said it may be linked to the “toxic” metals that are known to become stored away in our skeletons over time. He said, “We speculate that it may have something to do with the fact that bone acts as a repository for toxic heavy metals, such as lead…So when people get older, they lose bone (and) when this happens, these toxic metals are released back into the body and may adversely affect health…By preventing bone loss, bisphosphonates do prevent some of the toxic metal release.” “While we know this is the case, we don’t yet have evidence that this produces the survival benefit,” he added. He suggested that more studies on this account are need for exact explanation.
Prof Eisman went on to say that the study also showed the number of people actually receiving therapy. “Only about 30 percent of women and 10 percent of men with osteoporosis receive treatment, which is unacceptable when you consider that people could be helped, and death could be delayed by several years. There is good evidence – even without this study - that treating osteoporosis reduces fractures and reduces mortality,” he said.
Also according to the International Osteoporosis Foundation, it is not only women who are at risk; one in five men will suffer from this condition. They call it male osteoporosis - a silent epidemic.
Also research from Australia’s University of Melbourne has shown how osteoporosis is less common in males. For the study the researchers randomly assigned men aged 59 to 70 to one of four groups. One group took vitamin D and calcium supplements for the 18-month study. Another did specific exercises. A third group did both, and the fourth did neither. Exercising meant in the gym for 60 to 75 minute sessions on three non-consecutive days each week. Results showed that exercising was the best way, followed by taking vitamin D and calcium. Those supplements did not improve the outcome for men who also exercised.
Dr. Shoba Rao of the University of Texas noted some additional factors in a recent issue of American Family Physician. She writes that all men should be counselled on lifestyle measures such as smoking cessation, limiting alcohol consumption to less than two drinks per day and limiting caffeine and salt. Low testosterone levels can also be a factor, and these do tend to drop with age.
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