Since the 60s, the medical community has seen a significant increase in osteoporosis and its attendant morbidity and mortality. Countless hip fractures and deaths have been reported in patients with osteoporosis, especially in the elderly population.

Over the past 20 years, a lot of effort has been placed on preventive methods like addition of calcium to diet, ambulation and use of certain drugs. Finally, now there is a study which shows that the rates of hip fracture and deaths related to osteoporosis are on the decline. In the latest Journal of the American Medical Association (Oct 14, 2009), researchers published their data on declining fractures and death rates in the US. While they do not give the exact cause for this decline, they do praise life style changes and possible use of pharmaceutical medications as possible contributors. Other factors that may have played a role in this decline could be discontinuation of smoking, vitamin D supplementation, a higher emphasis on exercise and restriction on alcohol intake. Further, researchers claim that improved public education and physician awareness of osteoporosis since 1995 have cultivated changes in lifestyle that has led to the decline in hip fractures and death rate.

Hip fractures are not benign and carry a high morbidity and mortality. Each year, 30 percent of individuals who endure hip fractures die the subsequent year, and many experience long-drawn-out functional loss of their limb(s), remain disabled and the economic cost is huge. It is estimated the average cost for a hip fracture in the US can cost upwards of $40,000 in the first year alone.

In the present study, researchers analyzed Medicare data of 786 717 hip fractures from 1985-2005. The data revealed that more than three quarters of hip fractures occurred in women between the ages of 75-84.

While there is no single factor which accounts for the decline in hip fractures and death rate, it is suspected that use of bisphophonates may be the key. Many short term studies on bisphophonates have shown these drugs to strengthen bone and prevent bone loss. In addition, there have been tremendous improvements in surgical management of patients with hip fractures over the past 2 decades and this probably accounts for the low death rates. Moreover, there is a better awareness of morbidity of hip fracture and aggressive discharge to rehabilitation centers may have contributed to improved outcomes.

The research also showed that people who develop hip fractures usually have other concomitant disorders like congestive heart failure, chronic pulmonary obstructive lung disease and diabetes. Clearly the data are refreshing and perhaps changes in life style do make a difference when it comes to health.

For many years it has been known that professional footballers suffer from a variety of injuries during their career. While most injuries happen during their active football playing career, there is now evidence that footballers also have a higher rate of dementia than the general population. The issue about head injury in sports athletes made news in September when 3 NFL players declared that they will donate their brains for clinical research after death.

The frequent head concussions and contusions that occur during a players football days do have a poor outcome in the long run. A recent study commissioned by the NFL Players Care Foundation demonstrated that there was marked cognitive impairment not only among the retirees but also those players who were less than 50 years of age. For many years, the long term health consequences of playing in the NFL were neglected and now the league has decided to learn more about its retired players. The plan is to respond to the medical and physical needs of retired players.

The survey looked at 1000 retired players and collected information by telephone interview on a wide range of physical and mental health disorders. In cases where the player was unable to give a history, family or proxy was selected. Dr. Weir’s study demonstrated that the rates of dementia were quite high among retired footballers and some degree of dementia was even seen in footballers younger than age 50.

Following these news, the NFL players association announced the debut of a Concussion and Traumatic Brain Injury Committee. The plan is to promote ways to make an early diagnosis, treatment and prevent concussion/traumatic brain injuries in active players. There are also plans to evaluate more players and follow them for a long term period to determine if there is any correlation between head trauma and dementia later in life.

Said the NFLs executive director, DeMaurice Smith, in a news release, “This committee was designed to bring both independence and expertise to the ongoing analysis of serious head injuries so we can better protect our players,”

The recent survey was only a cross sectional analysis and did not establish a direct relationship between dementia and football/head trauma. However, this study does raise more questions and warrants additional study to determine if any such relationship exists. This study could have inferences beyond the NFL- what happens to head injuries suffered by athletes at high school and/or college level football? Do head injuries occurring at such a young age need follow up and what is the treatment?

Says Dr Weir who undertook the study, “”Dementia is much more difficult to report in surveys in part because it affects the respondent’s ability to participate,” he further added that “We conducted interviews with a proxy reporter — generally the wife — of the players who were unable to answer for themselves. We did not administer cognitive tests and did not conduct neurological examinations.”
It has been known for some time that the most common complaints among retired NFL payers are development of arthritis and muscle/joint pain. While it may sound like playing for the NFL is all bad news, there is some good news. The survey indicated that these players also have much fewer heart attacks and strokes then non-sporting men of comparable age.

If you haven’t been hitched by the “whole grain” bug, then you will be soon! Continue Reading