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As we age, low bone density, a thinning skeleton, and the strong possibility of disabling fractures are serious realities. But diagnosed early, fragile bones and full-blown osteoporosis can be managed, and fractures can be prevented.

It's important to communicate with your healthcare provider about this common disease. Screening for osteoporosis is just as important as being tested for blood pressure, cholesterol, and kidney and liver function. Bone health should be part of every senior's wellness examination.

Questions to Ask

• Ask your doctor for a bone densitometry test by age 65 if you are a woman, by age 70 if you are a man.

• Request a bone test earlier if you have had early menopause, surgical or natural; or had any treatments that lower sex hormones -- estrogen if you are woman, testosterone if you are a man. These types of medications may be given as part of breast or prostate cancer treatment.

• Tell your doctor about any medical conditions you have had, especially ones that require long-term use of corticosteroid drugs, since these can impair bones -- for example, inflammation-related conditions such as rheumatoid arthritis, asthma, and inflammatory bowel disease. Diabetes, seizure disorders, thyroid disease, and some cancers can promote low bone density, as can celiac disease and other digestive disorders that interfere with the absorption of nutrients in the intestines.

• To help you understand why osteoporosis develops, ask your doctor to explain your skeleton's dynamic process of bone modeling -- how it continuously breaks down old bone and lays down new bone -- and how this balance can be interrupted and lead to osteoporosis.

• If you need osteoporosis treatment, ask your doctor to explain the different therapeutic options and modes of delivery and frequency/duration, depending on the severity of your disease and your fracture risk. Some drugs slow the process of bone breakdown, allowing more time for new bone formation, while others actively build bone from the start.

• Inquire about medication side effects, but bear in mind that the risk of having a debilitating hip or other fracture outweighs drug-related complications. Some side effects can be avoided by having drugs delivered by infusion rather than taken orally. Serious side effects such as jaw problems and mid-thigh fractures are rare.

• Be honest with your care provider about any personal habits that may impact bone health. These include a diet deficient in protein, calcium, and vitamin D, as well as smoking, excessive alcohol consumption, and a sedentary lifestyle.

• Going forward, ask your doctor about the important issue of preventing falls to avoid fractures, which is the main goal of osteoporosis care. This may require adjustments to your daily living arrangements, such as using a walking device, reducing stair use, improving lighting, and removing obstacles.

With the right treatment, a good diet, and bone-strengthening physical activity, people diagnosed with osteoporosis can look forward to a long and good quality of life.

Read previous installments in this series:

For Your Patients: Osteoporosis -- the 'Silent Thief'

For Your Patients: What to Know About Osteoporosis Diagnosis and Treatment

For Your Patients: Osteoporosis and Fractures

For Your Patients: Men Get Osteoporosis, Too

For Your Patients: Medical Conditions That Raise Your Risk of Osteoporosis

"Medical Journeys" is a set of clinical resources reviewed by physicians, meant for the medical team as well as the patients they serve. Each episode of this journey through a disease state contains both a physician guide and a downloadable/printable patient resource. "Medical Journeys" chart a path each step of the way for physicians and patients and provide continual resources and support, as the caregiver team navigates the course of a disease.