Posted by on April 7, 2014 - 8:41pm

Drinking milk is not just for kids but also for post-menopausal women, new research shows. A new study from the Women's Health Initiative just published by the North American Menopause Society, reveals that calcium and vitamin D after menopause can improve women's cholesterol profiles.

Over 600 women took either a supplement containing 1,000 mg of calcium and 400 IU of vitamin D3, or a placebo, daily. Women who took the supplement, unsurprisingly, were two times more likely to have sufficient vitamin D levels (at least 30 ng/mL), in comparison to the women were taking placebo. Women who were taking supplements also had LDL (the "bad" cholesterol) numbers that were 4 to 5 points lower than the women taking placebo. The women on supplement also had higher levels of HDL (the "good" cholesterol) and lower levels of triglycerides.

Researchers agree that more work needs to be done to see whether or not supplementing one's diet with calcium and vitamin D can lower cholesterol levels and ultimately improve rates of cardiovascular disease in women after menopause. These results, however, show that there may potentially be extra benefits for those with calcium and vitamin D deficiencies to start supplements. Supplementing may be key for strengthening both the heart and bones after menopause. To learn more about healthy choices you can make after menopause, visit Northwestern's menopause website here.

“Calcium/vitamin D supplementation, serum 25-hydroxyvitamin D concentrations, and cholesterol profiles in the Women’s Health Initiative calcium/vitamin D randomized trial,” will be published in the August 2014 print edition of Menopause.


Posted by on May 13, 2013 - 12:25pm

The density of bones, measured as bone mineral density (BMD), is strongly related to osteoporosis.  Elderly women with osteoporosis, in particular, are at increased risk of fractures of the hip, arm, and spine; such fractures often relate to severe disability.  With data on alcohol collected as part of a clinical trial on the prevention of osteoporosis, investigators in Finland have related alcohol consumption to changes over three years in BMD.  After those excluded due to incomplete data, data on 300 women were available for analysis.  The majority of women were abstainers or consumed little alcohol.  Nevertheless, the results support much earlier research: regular, moderate drinking is associated with higher levels of BMD (i.e., lower risk of osteoporotic fractures) than is abstinence.

Data from European surveys have shown that women in Finland tend to have high levels of osteoporosis and to drink very little; hence the increase in BMD associated with alcohol intake, even though slight, could be important in this population.  Over the past three decades, there has been an increase in alcohol consumption in Finland, especially a marked increase in the consumption of wine.  Hence, some Forum reviewers thought that the improvement in BMD among drinkers in this study may have been primarily from wine (which may have additional components, other than alcohol, that relate to BMD).  However, the number of subjects was not large enough to test this hypothesis in the present study.  Overall, this study supports the premise that moderate alcohol intake, along with an adequate calcium intake and vitamin D and exercise, may have a favorable influence on the risk of developing osteoporosis

Forum reviewers, as did the authors, noted a number of limitations of the study: a rather small cohort with a very low intake of alcohol, a short duration of follow up, and rather small differences according to whether the women consumed alcohol or not.

Reference:  Sommer I, Erkkilä AT, Järvinen R, Mursu J, Sirola J, Jurvelin JS, Kröger H, Tuppurainen M.  Alcohol consumption and bone mineral density in elderly women.  Public Health Nutr 2013;16:704-712.  doi: 10.1017/S136898001200331X.

Posted by on April 10, 2013 - 12:17pm

Last week Health Canada released an official warning on the association of increased risk of bone fracture with the frequent use of Proton-Pump Inhibitor (PPI) medications, used to treat symptoms of  acid reflux and gastroesophegeal reflux disease (GERD).   While an important step, this warning, like the U.S. FDA’s before it, does not go far enough in ensuring that the public is aware of the immense risks posed by continuous dosages of PPI pills, particularly to women.

According to the alert, “several scientific studies suggest that PPI therapy may be associated with a small increased risk for fractures of the hip, wrist, or spine related to osteoporosis, a disease resulting in the weakening of bones.”  They added that “the risk of fracture was higher in patients who received multiple daily doses of PPIs and therapy for a year or longer. Additional risk factors for osteoporosis, such as age, gender and the presence of other health conditions, may also contribute to the increased risk of fractures.”[1]  Though the alert mentions that gender could also contribute to the increased risk, what the alert fails to mention is that women face the greatest risks when taking these pills.

Last year, a team of researchers from Harvard Medical School and Boston General Hospital in a study  focusing on over 80,000 post-menopausal women, found that among those who had taken PPI pills 3-4 times per week over a two-year period had an increased risk of hip-fracture of 35%.  For current and former smokers, the increase was as high as 50%.[2] A common theory for the cause of this increase is the fact that the pills inhibit the body’s ability to intake calcium, an essential element for maintaining strong bones.

These aren’t the only problems associated with PPI pills, however.  Though the warning labels on nearly all PPI’s, including those sold by major brands like Prilosec®, Nexium®, and Prevacid®, state that the pills should be taken for a maximum of fourteen days annually, many patients continue with daily therapy for years.  These medications,, which treat short-term symptoms of acid reflux by blocking the stomach’s natural production of acid, have serious negative side-effects.  According to the FDA, prolonged dosages of PPI pills can lead to an increase in risk of pneumonia, heart arrhythmia, and Clostridium difficile–associated diarrhea.[3]  Worse, according to a study by Dr. Blair Jobe at the University of Pittsburg, those taking PPI pills regularly to treat mild symptoms were 60% more likely to suffer from Barrett’s Esophagus, which often leads to esophageal cancer.[4]

In response to Health Canada’s warning, Dr. William Dengler, Medical Director of RefluxMD, issued this response: In light of a recent warning by the Canadian federal government,  PPI users and their physicians should carefully consider the long-term side effects when using these drugs.  These same side effects are responsible for the U.S. FDA placing this class of drugs on their "watch list."  With multiple governments warning patients that the side effects for acid reflux medications are troublesome, the media should play a larger role in combatting the over-saturation of television marketing for the drugs.”[5]  More importantly, however, consumers, particularly women, should pay careful attention to the risks associated with PPI pills before starting treatment, as well as consider natural alternatives that could help to treat long-term causes of acid-reflux, rather than short-term symptoms.

Guest Blogger:  Alexander Michael Jakubowski, Northwestern Undergraduate Student

Posted by on October 17, 2012 - 1:18pm

Our success as researchers is measured by our ability to translate our findings, according to the often-used phrase, from bench to bedside.  In other words, if we can apply our basic science findings to clinical care, we have the ability to impact countless lives.  This pipeline is a national priority, and in fact, many Academic Medical Centers have established programs to facilitate rapid clinical translation.  However, equally as important, and perhaps less appreciated is the need to translate basic science findings into relevant policies that protect and influence the general public.

Reproductive science and medicine are greatly impacted by the environment. Trends in reproductive health demonstrate that reproductive function has declined since the mid-20th century in certain populations and locations [1].  Coincident with this decline in reproductive function is the large and ever-increasing number of natural and synthetic chemicals to which humans are exposed [2, 3].  Basic, clinical, and epidemiological research has demonstrated that exposure to certain compounds and contaminants, such as Endocrine Disrupting Chemicals (EDC), can have negative impacts on reproductive health. These compounds interfere with the production, transport, activity, and metabolism of natural hormones in the body. As we, as basic scientists and clinical researchers, understand the mechanisms by which these environmental exposures to such compounds affect developmental, reproductive, and neuroendocrine functions, we must also be able to inform and educate the implications of these specific reproductive health findings to the decision makers in Washington, DC.  The question is: How?

In  2010, the Program on Reproductive Health and the Environment at the University of California, San Francisco developed the Reach the Decision Makers Fellowship with the exact intent of providing interested individuals and teams with the resources to advance science-based policy solutions.  Specifically the Reach Program serves to provide individuals with a distinct interest in reproductive health and the environment, with mechanisms to interact with the United States Environmental Protection Agency (US-EPA).  Over the past two years, the Reach program directed by Tracey Woodruff, PhD, MPH, an esteemed leader in the field, has trained over 75 individuals nationwide based on the principles of participatory democracy, social justice, and taking action to prevent harm (for more recent news about the Reach Program, check out the following blog written for the Physicians for Social Responsibility).

Table 1. Our interdisciplinary team

To take advantage of this unique program, we assembled an interdisciplinary team of six individuals committed to reproductive health and the environment (Table 1).  Our team is comprised of professionals from academia, health care, government, and the community, and collectively we have experience in research, policy, advocacy, teaching, and communication (Table 2).   Prior to joining the Reach Program, our team has worked together at Northwestern University and Northwestern Memorial Hospital in various settings including the Women’s Health Research Institute, the laboratory of Teresa K. Woodruff, PhD, the Oncofertility Consortium, the National Physicians Cooperative, the Oncofertility Saturday Academy, and the proposed Northwestern University Superfund Research Center in Reproductive Health Hazards. We joined the Reach Program with the goal of ensuring that the manner in which the US-EPA evaluates reproductive health and toxicity is in line with the current state of scientific knowledge.

Table 2. Team backgrounds

As Reach Program fellows, we have participated in a rigorous training program to define a reasonable “ask” in relation to our goal, to perform research on the topic, and to learn how to identify the key decision makers within the US-EPA who will listen to our request and affect change.   Over the past six months, we have engaged in a first trip to Washington, DC where we attended presentations from policy experts regarding the US-EPA hazard evaluation procedures and how scientists can inform the agency on emerging research regarding the effects of environmental toxins on reproductive health. Meetings at the US-EPA gave the team a greater understanding of the overall institution and current initiatives of the agency. We have also participated in nine webinars covering topics spanning from the effects of environmental toxins on reproductive health to identifying policies and policy makers at the US-EPA.

We also developed our policy project by systematically gaining an understanding of the US-EPA as an agency and the documents and guidelines that inform its staff. Members of the US-EPA helped us identify a principle document in reproductive health and the environment, the Guidelines for Reproductive Toxicity Risk Assessment. This document was written in 1996 and has not been revised since that time so our group decided to focus on some of the significant opportunities to improve upon the guidelines. Since 1996, the state of reproductive research has advanced and we identified three specific areas of research that could be prioritized during the updating of the Guidelines for Reproductive Toxicity Risk Assessment, as follows:

  • While the Guidelines acknowledged the importance of non-reproductive consequences of an impaired reproductive system, such as osteoporosis and increased risk of stroke, they did not include these outcomes as endpoint measures for further research study.
  • Model organisms are necessary for advancing research in reproductive and environmental health. In the Guidelines, the authors state that effects seen in one organism may be assumed to occur in another. While this is meant to be protective for unstudied species, it is also true that certain species are ideal to investigate different aspects of science and health. Thus, we encourage the study of multiple model organisms in reproductive health and the environment.
  • Research advances over the past decade have shown that significant sex differences are seen in the way males and females respond to different drugs and environmental toxins. This warrants the need to include both sexes in reproductive research, a consideration that could strengthen the updated Guidelines.

Our team developed these ideas into a position statement to inform US-EPA staff and interested parties of the need to advance reproductive health and the environment. This project culminates tomorrow, Thursday, October 18, 2012 when the team will fly to Washington, D.C. to meet with Nica Louie (Environmental Health Scientist at the National Center for Environmental Research), Brenda Foos (Director, Regulatory Support and Science Policy Division, Office of Children's Health Protection), and Daniel Axelrad (Environmental Scientist, Office of Policy) at the US-EPA. We hope to gain a greater understanding of the procedures of the agency at these meetings and advocate for the need to update Guidelines for Reproductive Toxicity Risk Assessment.

Virginia Neale, the Associate Director of Government Relations for Northwestern University, will also join the team and bring her expertise in bridging academia and the government to the project. Neale also facilitated a meeting between team members and legislative assistants to the House of Representatives congresswoman Jan Schakowsky (D-IL), who resides over Northwestern University’s Evanston campus. As congressional requests to the US-EPA are often needed to gather teams of experts and update guidelines, we will ask Schakowsky’s office to make such a request to gather the National Academy of Sciences and revise the Guidelines for Reproductive Toxicity Risk Assessment.

The work done this week, and over the past six months, by this interdisciplinary group, will build the foundation for the team to continue communicating evidence-based reproductive health findings to the policy makers in Washington D.C. who have the ability to affect change on a federal level. The relationships we develop this week will be fostered in the coming months and years to ensure that reproductive health is promoted at the highest level within the EPA and advocate that US-EPA guidelines are updated to include the most recent advances in reproductive research

This blog was Contributed by Francesca Elizabeth Duncan, PhD and Kate Waimey Timmerman, PhD    Read more about the team here in a Northwestern University press release.

1.         Woodruff, T.J., J. Schwartz, and L.C. Giudice, Research agenda for environmental reproductive health in the 21st century. Journal of epidemiology and community health, 2010. 64(4): p. 307-10.

2.         Sutton, P., L.C. Giudice, and T.J. Woodruff, Reproductive environmental health. Current opinion in obstetrics & gynecology, 2010. 22(6): p. 517-24.

3.         Woodruff, T.J., et al., Proceedings of the Summit on Environmental Challenges to Reproductive Health and Fertility: executive summary. Fertility and sterility, 2008. 89(2 Suppl): p. e1-e20.

Posted by on June 13, 2012 - 1:10pm

The esophageal cancer risk with bisphosphonate bone drugs may be a bigger problem than thought, particularly with use of alendronate (Fosamax), an adverse event surveillance study suggested.  Overall, 128 cases of bisphosphonate-associated esophageal cancer were reported to the FDA's adverse event reporting system (AERS) from 1995 through 2010, Beatrice J. Edwards, MD, of Northwestern University and colleagues found.

That risk appeared disproportionate with alendronate, the group reported in an abstract presented at the American Society of Clinical Oncology held in Chicago recently. That particular bisphosphonate accounted for 75% of the esophageal cancers seen with bisphosphonates in the FDA database -- 6.4 times more than with any other drug in the class.

"Our analysis of FDA AERS identifies a larger number of cases of esophageal cancer than previously described, and a significant safety signal with alendronate use," they noted. "Increased awareness and vigilance is needed for patients receiving oral bisphosphonate therapy."

A 2009 FDA analysis had pointed to 23 such cases with alendronate since initial marketing in 1995.   At that time no other oral bisphosphonate had any reports of a link to esophageal cancer in the adverse event reporting database, though a handful of cases with risedronate (Actonel), ibandronate (Boniva), and etidronate (Didronel) had been reported in Europe and Japan.

A subsequent British registry study suggested elevated risk with prolonged use of oral bisphosphonates, but an FDA advisory panel cited a lack of solid evidence.

Edwards' group updated the analysis of adverse event reports received by the FDA by searching the AERS database for terms related to esophageal cancer in combination with all drug names for bisphosphonates over the period from 1996 to 2010.    The esophageal cancer events they found associated with bisphosphonate use were 96 cases with alendronate, 14 with risedronate, 10 with ibandronate, seven with zoledronic acid, and one with pamidronate (Aredia).

Barrett's esophagus was listed in three of the cases, which led the researchers to recommend avoiding oral bisphosphonates for patients with this risk factor for esophageal cancer and also for those with persistent mucosal abnormalities.

"Esophagitis has been associated with oral bisphosphonates," Edwards' group noted. "Erosive esophagitis and persistent mucosal abnormalities have been noted with crystalline material (similar to ground alendronate)."

Posted by on February 23, 2012 - 7:54am

Older, postmenopausal women who take popular medications to control indigestion and heartburn called proton pump inhibitors (PPIs)  may put themselves at higher risk for hip fractures according to new research by Dr. Hamed Khalili, from Massachusetts General Hospital in Boston.  Long-term use of these drugs may increase that risk by 35 percent and even higher (to 50 percent) in smokers.    Some examples of these medications are shown here.

According to the researchers, PPIs are strongly indicated in some patients for short term use, but they should be closely monitored if long term use is needed.  Dr. Khalili's data supports the recent decision by the U.S. Food and Drug Administration to revise labeling of PPIs to incorporate concerns about a bone fractures with use of these products.  

For the study, they looked at data from 80,000 postmenopausal women. .Over the course of eight years, almost 900 hip fractures occurred -- a 35 percent increased risk for women using PPIs compared to women who didn't take the drugs.   In absolute terms, the risk of hip fracture works out to about 2.02 fractures for every 1,000 person years for those taking PPIs, compared with 1.51 fractures per 1,000 person years. Person years are the number of years in a study multiplied by the number of people in the study.  The increased risk of fractures among women who smoked was even higher. The longer a women took a PPI, the more her risk increased.

In 2000, 6.7 percent of the women used PPIs regularly, generally for acid reflux; by 2008 that had jumped to 18.9 percent. This could mean that more fractures will be seen in years to come.   Women who stopped using PPIs saw their risk of hip fracture return to normal within two years, Khalili's group noted.   Women are also cautioned not to suddenly quit their PPI and gradual tapering is recommended to avoid acid rebound.   Often, calcium supplements are used to bolster bone strength, but because PPIs affect the absorption of calcium, taking calcium supplements may not be effective.  The researchers did take calcium supplement use into account and the risk remained.

SOURCE:  Jan. 31, 2012, BMJ, online



Posted by on January 31, 2012 - 3:15pm

Experts recommend that older women have regular bone density tests to screen for osteoporosis. But it's been unclear how often to repeat the tests. A study of nearly 5,000 women now reports that patients with healthy bone density on their first test might safely wait 15 years before getting rescreened.

Osteoporosis is a disorder marked by weakened bones and an increased risk of fractures. More than 40 million people nationwide either have osteoporosis or are at increased risk for broken bones because of low bone mineral density (osteopenia). Osteoporosis is often called a “silent disease” because it usually progresses slowly and without symptoms until a fracture occurs. When low bone density is identified early through screening, lifestyle changes and therapies can help protect bone health and reduce the risk of fractures. That's why the U.S. Preventive Services Task Force recommends routine screening of bone mineral density for women ages 65 and older.

To help doctors decide how often to repeat bone density tests in women who don't have osteoporosis at their initial screening, a research team led by Dr. Margaret Gourlay of the University of North Carolina at Chapel Hill analyzed data on nearly 5,000 women, age 67 or older.  They divided the women divided into 4 groups based on initial bone density tests that were either normal or showed mild, moderate or advanced osteopenia. They were given 2 to 5 bone density tests at varying intervals during the 15-year study period.

As reported in the January 19, 2012, issue of the New England Journal of Medicine, the scientists found that less than 1% of women who initially had normal bone mineral density went on to develop osteoporosis during the study. Only 5% of those with mildly low bone density at the start made the transition to osteoporosis. Overall, the data suggest that women in these 2 categories might safely wait about 15 years before being rescreened for osteoporosis.

The scientists also found that about 1 in 10 women with moderate osteopenia at baseline developed osteoporosis within 5 years. For those with advanced osteopenia at the start, about 10% had developed osteoporosis within a year, suggesting that 1-year screening intervals might be advisable for this group.

“If a woman's bone density at age 67 is very good, then she doesn't need to be rescreened in 2 years or 3 years, because we're not likely to see much change,” Gourlay says. “Our study found it would take about 15 years for 10% of women in the highest bone density ranges to develop osteoporosis. That was longer than we expected, and it's great news for this group of women.”

These findings can help guide doctors in their bone screening recommendations. Other risk factors, such age, medications or specific diseases, would also influence screening frequency.

Osteoporosis: The Bone Thief:
Bone Mass Measurement: What the Numbers Mean:
Keeping Bones Strong and Healthy:

Source:  NIH Research Matters,  a weekly update of NIH research highlights from the Office of Communications, National Institutes of Health.

Posted by on November 27, 2011 - 1:12pm

The Old--remember these?

Remember those weight loss machines that consisted of a vibrating belt you put around your waist?   They were often part of a comedy routine on early TV.  Well,  they are back in the form of a whole body vibration machine.

With the new whole body vibration, you stand, sit or lie on a machine with a vibrating platform. As the machine vibrates, it transmits energy to your body, forcing your muscles to contract and relax dozens of times each second. (The old version only shook the belt)  You may feel as if you're exerting yourself when you do whole body vibration. You can find a whole body vibration machine at a local gym, or you can even buy one for home use.

The New --Whole Body Vibration Machine

Advocates say that as little as 15 minutes a day of whole body vibration three times a week can aid weight loss, burn fat, improve flexibility, enhance blood flow, build strength and decrease the stress hormone cortisol.   But comprehensive research about whole body vibration is lacking. It's not yet clear if whole body vibration provides the same range of health benefits as exercise you actively engage in, such as walking, biking or swimming. Some research does show that whole body vibration may help improve muscle strength and that it may help with weight loss when you also cut back on calories.

One of the selling points of this machine is the belief that it may increase bone mineral density and thus help prevent osteoporosis.  But a new study does not support this hypothesis.

A year of whole-body vibration (WBV) did not alter bone mineral density (BMD) or bone structure in postmenopausal women taking vitamin D and calcium supplements, Canadian researcher Angela Cheung, MD, and colleagues from the University Health Network in Toronto reported.

"Whole body vibration has been introduced in the past decade as a promising new anti-osteoporotic therapy, because significant improvements in bone formation, BMD, and cortical thickness were found in animal models," wrote the authors.   "Although commercially available WBV devices are marketed to and used by patients," they continued, "the beneficial effects of WBV on fracture risk and BMD have not been established, and recent randomized, controlled trials in postmenopausal women have shown conflicting results."

To clarify the issue, the researchers studied healthy postmenopausal women with BMD T-scores between -1.0 and -2.5 who were not prescribed bone medications. (A T-score between +1 and −1 is considered normal or healthy. A T-score between −1 and −2.5 indicates that you have low bone mass, although not low enough to be diagnosed with osteoporosis. A T-score of −2.5 or lower indicates that you have osteoporosis. The greater the negative number, the more severe the osteoporosis). Patients were randomly assigned to three groups: two groups were asked to stand on a low-magnitude WBV platform for 20 minutes daily, and the third group served as the control group.

The groups did not differ in the number of clinical fractures during the period.  None of these fractures that did occur were  related to frailty because they were caused by car, household, or sporting accidents or involved only the small bones of the foot.

"[Twelve] months of low-magnitude WBV at either 90- or 30-Hz had no effect on BMD or bone structure in healthy, community-dwelling, postmenopausal women who received calcium and vitamin D supplementation, and thus is not recommended for preventing age-related bone loss in this population," wrote the researchers.


Posted by on November 4, 2011 - 3:20pm

Are you or a family member at risk for osteoporosis--a serious, potentially debilitating condition more prevalent in women? Over the past decade a number of treatments have become available including bisphosphonates.   An excellent one-page summary of benefits and risks is now available from the Hormone Foundation and should be read by all who are considering treatment.

Click HERE to view the article.

Posted by on October 14, 2011 - 1:06pm

Recent Height Loss Predicts Hip Fracture Risk in Elderly, says Institute for Aging Research Study--Simple Measurement May Help Protect Seniors from Major Public Health Threat

Elderly men and women who lost height over a two-year period are up to 54 percent more likely to suffer a hip fracture than those whose height was unchanged, according to a new study from the Institute for Aging Research of Hebrew SeniorLife, an affiliate of Harvard Medical School.    “Recent height loss in both elderly men and women appears to provide a simple indication of who’s at risk for hip fracture,” says lead author Marian T. Hannan, D.Sc., M.P.H., a senior scientist in the Institute’s Musculoskeletal Research Center. This information, she adds, could prompt clinicians, seniors and their families to take measures to prevent potential falls and hip fractures.

Published online in the Journal of Bone and Mineral Research, the study found that recent height loss, for both men and women, was associated with a 21 percent to 54 percent increased risk for hip fracture within a subsequent two-year period for every inch of height lost. Men with long-term height loss of two inches or more had nearly twice the risk of fracture than men with less height loss.

Hip fracture has become a major public health concern in the United States. More than 300,000 Americans fracture their hip each year, most of them over age 65, often leading to significant functional impairment, nursing home admission, and death. According to the Centers for Disease Control and Prevention, nearly 20 percent of hip fracture patients die within a year of their injury. Hip fractures cause more deaths, disability and increased health-care costs than all other fractures combined.

The study examined height measurements and hip fracture rates over a 24-year period for 3,081 adults from the Framingham Heart Study, as well as a shorter, two-year term when study participants were elderly. Long-term height loss was calculated as the difference between height measurement at the initial 1948 Framingham examination and the baseline examination for this study in 1974-75. Recent height loss was the two-year loss measured during exams conducted every two years after the baseline exam. Hip fractures were determined through a review of hospital, medical and surgical records, as well as imaging reports.

Height loss was associated with a 40 percent to 54 percent increased risk of hip fracture in men for both long-term and recent height loss; older women with recent height loss had a 21 percent chance of fracturing their hip. Muscle weakening, postural changes, disc degeneration, joint space narrowing, and spinal deformities may all contribute to height loss, says Dr. Hannan, an associate professor of medicine at Harvard Medical School. Kyphosis, or curving of the spine that causes a bowing of the back, may also contribute to height loss and fracture risk.

Current risk assessment tools only consider a patient’s current height, not their amount of height loss. The ability of tools such as bone density testing and computed tomography to predict fracture risk may be enhanced by adding simple height measurements. “Height loss is easily measured,” says Dr. Hannan, “and may indicate potential for subsequent hip fracture, and thus could serve as an alert to clinicians and elders to seek medical evaluation.”

If an older person notices that he or she is losing height, Dr. Hannan says it is reasonable to convey this information to a health-care provider and ask about screening for osteoporosis or the likelihood of a future fracture.

Dr. Hannan’s study was funded by the Arthritis Foundation and the National Institutes of Health.