Causes and Treatments for Osteoporosis

Sep 5, 2021

As we age, our bodies become a little less agile and a little more fragile. Bone health is especially important to manage as we get older because oftentimes our bones weaken and can develop into a condition known as osteoporosis. While it is not always entirely preventable, understanding the causes and treatments for osteoporosis can help.

Signs of osteoporosis
As we already pointed out, osteoporosis is a weakening of the bones resulting from a decline in bone density where small holes form within the bone. As we age our bones become thinner and less capable of withstanding impact or supporting movement, thereby becoming more likely to break.

Osteoporosis frequently develops slowly over a long period of time, allowing it to go unnoticed. However, decreasing bone density makes these individuals more susceptible to bone fractures without exerting much physical activity. For instance, fractures can easily occur from a fall or even from something as simple as doing household tasks.

Fractures most often occur in the hip, spine, and wrist, as these areas of the body are vulnerable to movement. The most serious complications that arise are from hip fractures. The hips absorb most of the impact when we walk. We also tend to lose our balance as we age, which increases the risk of falling or tripping, causing an injury or bone break. Seniors who suffer from a hip fracture can have difficulties recovering and are often restricted to the use of a cane or wheelchair for the remainder of their lives.

Causes and preventions of osteoporosis
Roughly 54 million Americans suffer from osteoporosis or low bone mass. On average, about one in two women or one in five men over age 65 will incur a fracture because of osteoporosis. However, being aware of the causes of bone loss can help determine your risk of getting osteoporosis.

Factors such as demographics, body composition and lifestyle or habits can put you at higher risk for osteoporosis. Here are a few to consider:

  • Age: Everyone loses bone density as they age. Beginning in our 30s, the body starts to build less new bone to replace the old bone, essentially decreasing bone growth and strength. Although osteoporosis can surface at any age, it takes time to form, making it more likely in people 65 and older.
  • Body size: Individuals with naturally petite and thin body sizes are more likely to develop bone fragility.
  • Ethnicity: Research shows Caucasians and Asians are at a higher risk of developing osteoporosis.
  • Family history: If you or members of your family have a history of broken bones or osteoporosis, you are at a greater risk for the disease.
  • Nutrition: Low body weight, poor diet or nutrition, and decreased intake of calcium and vitamin D can lead to osteoporosis.
  • Lifestyle: Bones can weaken when accompanied by low activity rates, alcohol, and smoking.
  • Medications: Certain medications such as steroids can increase your likelihood of bone loss.

Diagnosing osteoporosis
Osteoporosis is most commonly identified with a bone density test. At the age of 65 for women and 70 for men, a bone density test should be administered, if not before. Many doctors recommend that women receive the test once they begin menopause, due to the body’s natural decrease in estrogen which is a bone-building hormone.

A bone density test is a safe, non-invasive X-ray that compares your current bone density to your peak bone density during the ages of 20 to 25, depending on your gender and ethnicity.

If you are diagnosed with osteoporosis, follow-up bone density scans will help monitor its progression and indicate how well the treatment plan is working. Additional tests, such as a complete physical, skeletal x-ray, and specified laboratory tests may also be applicable to determine the extent of the condition.

Treatment for osteoporosis
Unfortunately, bone loss is not something that can be replenished, so treatment plans are primarily focused on reducing further loss. The treatment team is often a coordination between your primary care physician, an endocrinologist, gynecologist, and/or orthopedist.

Key treatments include increasing physical activity and exercise, consuming a healthier diet that includes more leafy greens and foods high in calcium, physical therapy to improve mobility and help prevent falls. Doctors may also prescribe calcium and vitamin D supplements and medications that can regenerate the production of estrogen and protect bone mass.

Osteoporosis prevention
Taking proactive steps to prevent bone loss begins with nutrition. A diet rich in calcium and vitamin D is vital, as they are the most prominent bone-building elements and will lower the risk of osteoporosis. Calcium keeps your bones strong while vitamin D is responsible for the retention of calcium. Men and women ages 19 to 50 need at least 1,000 milligrams of calcium per day. After age 50, the body needs roughly 1,200 to 1,500 milligrams each day. Likewise, men and women ages 19 to 70 need 600 IU (International Unit) of vitamin D each day. After age 70, the body needs 800 IU per day. But how can you get an adequate amount?

One way to get a good dose of vitamin D is sun exposure for at least five to 15 minutes per week and managing a diet of dairy, greens, juice, fish, and grains. For those who are lactose intolerant, there are other sources of calcium and vitamin D available. These include sardines, tuna, salmon, spinach, orange juice, broccoli, kale, collard greens, beans, nuts, seeds, legumes, and other common greens.

Exercise is another important practice for prevention. Just as it is important to continue to stretch and tone muscles, an active lifestyle helps maintain bone strength. A good goal is to undergo weight-bearing exercise for at least 30 minutes three to four times a week. Weight-bearing does not necessarily mean lifting dumbbells. It can be any exercise that utilizes your body’s muscles and bones while working against gravity. With regular weight-bearing activity, bones build additional cells that make them stronger. Following is a list of bone-building activities to consider:

  • Brisk walking, jogging and hiking
  • Tennis or other racquet sports
  • Team sports, such as soccer, baseball, or basketball
  • Dancing, step aerobics, and stair climbing
  • Weight training with light weights or machines

Swimming and biking are not weight-bearing activities, but they can be a good alternative if you have a health condition that prevents you from doing weight-bearing exercises.

Lifestyle or habits such as good food choices and increased physical activities are not enough to qualify as living a healthy lifestyle. Leading a healthier lifestyle requires cutting out harmful toxins, such as smoking (nicotine or recreational drugs) and drinking alcohol. Additionally, it’s important to check with your doctor and verify whether you have any vitamin or immunodeficiencies, or if you are taking any prescription drugs that could potentially decrease bone mass.

For more information on osteoporosis and how to prevent it, visit

Dr. Alina Walden – Vice President Clinical Services

Dr. Alina Walden is a highly accomplished professional with an impressive academic background. She holds a Bachelor of Science degree in Biochemistry and Molecular Cellular Biology from the University of Arizona Honors Program. Subsequently, she obtained her medical degree from New York Medical College and earned her MBA from the University of Phoenix.

With over 15 years of experience in clinical practice, Dr. Walden has specialized in risk adjustment, disease management, and utilization management. Her expertise as a physician executive, combined with an in-depth understanding of the CMS HCC-Risk Adjustment Model and Quality STAR measures, enables her to develop and implement effective population health programs. She is also certified as a Certified Professional Medical Auditor (CPMA), Certified Professional Compliance Officer (CPCO), Certified Professional Coder (CPC), and Certified Risk Adjustment Coder (CRC) from AAPC. These credentials align perfectly with the goals of Adobe Population Health.

Dr. Walden is committed to delivering exceptional customer service to the entire care team, consistently striving to enhance and promote positive patient experiences. She firmly believes that every individual involved in the healthcare process plays a crucial role in advocating best practices. Outside of her professional endeavors, Dr. Walden cherishes spending quality time with her family, which includes her loving husband and four children. Her personal interests include reading and traveling.

Gail Lara – Vice President Strategic Outreach

With extensive experience in healthcare marketing, operations and management, Gail has made a career of developing and growing service lines and businesses from large health systems and specialty practices to wellness and ambulatory services.

As a VP at Adobe Care & Wellness, she oversees outreach to physicians and identifies opportunities for growth that align with the needs of the community and its members.
Gail earned an associate degree in business at Midland College followed by a bachelor’s degree in marketing from the University of Texas. She then worked in operations and business development with a national company upon moving to Arizona and joining the state’s largest urgent care organization where she was instrumental in its growth, identifying new locations, opening clinics, and overseeing licensing, staffing, and compliance. Gail then built and grew service lines at a local hospital group and oversaw marketing and business development for another.

With a commitment to innovative thinking, Gail’s wide range of experience is enhanced by her ability to foster collaborative relationships to achieve goals.

Residents of Arizona, Gail, and her husband have three children. She is passionate about community service, has served on the board of the Arthritis Foundation, and regularly volunteers at The Society of St. Vincent de Paul.

Maria Martinez – Vice President Population Health

Maria Martinez started with Adobe Care & Wellness in the call center, making health risk assessment (HRA) calls to members. She soon took on new responsibilities, learning the ins and outs of Salesforce and helping to build the company’s initial technology platform. Maria never expected that her first post-college job would lead to a career in health care solutions. Maria was born and raised in Phoenix and earned a Bachelor of Science in justice studies with a minor in women and gender studies, graduating Summa Cum Laude. She quickly rose to Senior Director of Clinical Services at Adobe Care & Wellness and later to Vice President of Operations. As VP of Operations, Maria oversees the nurse practitioner scheduling and in-home assessments program to ensure members receive the care needed. She is passionate about making health care more accessible to those living in rural areas or lacking the mobility to get to a doctor’s office helping the company grow and expand its ability to help others.

David Heinrich – Vice President, Integrated Care

A Chicago native with more than 20 years of management experience, David began his management career in the retail industry, quickly working his way up to Store Manager and then Regional Manager. While overseeing multi-million dollar retail stores, David felt the pull to venture into the medical field. He began working for an ambulance company providing pre-hospital care to the sick and injured which inspired him to further his education in nursing school. As he earned his degree, David worked full-time doing organ and tissue recovery for one of the nation’s largest not-for-profit body donation programs.

Since graduating as a registered nurse, David has worked in medical-surgical, trauma, and telemetry units as well as in home health, hospice, and nursing education. He has held clinical leadership roles including Clinical Manager and Director of Nursing.

When Adobe Care and Wellness started their Special Needs Plan in 2019, David joined the team and quickly helped grow the program. He was promoted to Director of Case Management and then to Senior Director of Integrated Care. David, who is also a Certified Case Manager, now serves as Adobe’s Vice President of Integrated Clinical Services.

Alex Waddell – Chief Information Officer

Alex Waddell is an Arizona native and graduate of Arizona State University, where he earned a Bachelor’s in economics. Alex began his career in IT as a software developer for a home health and case management provider. Over the next four years, Alex took on increasing responsibilities and began earning certifications as a Salesforce developer. In 2018, he was hired as Director of Software Development for Outreach Health Services, where he worked for two years before accepting the position of Executive Vice President of Technology at Adobe Care and Wellness. Alex has continued his drive for excellence and is now a Certified Salesforce Application Architect as well as a member of the Forbes Technology Council. In his current position as CIO,  Alex manages and directs a team of developers and oversees the design and development of the proprietary software that supports the expanding healthcare solutions Adobe Care and Wellness offers. Alex and his department, provide internal staff and external entities with analytics that measures results and helps drives decisions. He and his team also ensure data security for the company’s hardware and software.

Chad Wolver – Chief Financial Officer

Chad Wolver is an Arizona native and graduate of University of Arizona’s Executive MBA program in Accounting & Finance. He brings nearly a decade of commercial banking, strategic finance and management experience to the leadership team. He first met our founders, Jayme and Pat, working as the banker for Adobe Care & Wellness in 2017. Chad has always had a passion for helping others. After completing undergraduate degree in Communications with a minor in mathematics at Arizona State University, he joined the US Peace Corps and spent four years in South Africa. In his role as CFO, Chad will develop the company’s financial strategy, oversee budget and planning, and help the organization grow efficiently in its goal to expand as a multi-state provider. Chad serves as a board member for some of Arizona’s most well-recognized philanthropic organizations including Arizona Community Foundation’s Kellenberger + Tollefson Center for LGBTQ Philanthropy Advisory Council and ONE Community’s Millennial Advisory Board. He’s a past board member of ASU Lodestar Center’s Leadership Council, Human Rights Campaign Arizona, Southwest Center for HIV/AIDS and Phoenix Community Alliance’s Social & Housing Advancement Committee. When Chad is not working or giving his time to one of the many causes and organizations he cares about, he enjoys traveling with his partner and spending time with their beloved Italian greyhounds.

Challas Ray – Chief Operating Officer

Challas Ray has spent more than a decade building a career in the health care industry. Challas holds a Master’s in Clinical Kinesiology from Eastern Illinois University. After completing his education, he began work with Sara Bush Lincoln Health System, where he helped create and expand an external wellness program for companies interested in providing wellness programs to their employees. Challas is originally from Toledo, Illinois, but now calls Arizona home.  He moved to the Valley of the Sun seeking warmer weather and new opportunities. Joining The Beech Group as a Transitional Specialist, it was there Challas met and began collaborating with Jayme Ambrose. In 2017, he joined Jayme’s team to help launch Adobe Care & Wellness. As Adobe Care & Wellness COO, Challas provides oversight of the operational process to improve efficiencies and conducts the cost-benefit analysis of new and existing initiatives.

Pat Duryea, PhD – Chief Inspiration Officer

Patricia (Pat) Duryea earned her bachelor’s in Business Administration with an emphasis in Human Resource Management from Arizona State University. She then served as a Human Resource Director for nearly six years before returning to school to earn a Master of Educational Psychology from Northern Arizona University and a Doctorate in Counseling Psychology from Walden University.  Through her career spanning three decades, Pat has worked as a clinical manager, employee assistance program director, an adjunct professor at ASU and she’s owned and operated multiple small businesses. She has extensive knowledge in developing health and wellness programs, and experience in trauma-related counseling. As Chief Inspiration Officer at Adobe Care & Wellness, Pat manages human resources and the development of company culture.  She also serves as the compliance officer, receiving complaints, solving issues and reporting them to Arizona Complete Health.  She works directly with the management team on leadership development within the organization and monitoring morale. Pat’s overall focus is to ensure that employees feel included and valued in their contributions to the company’s success and to provide them with the opportunity to be the best they can be.

Jayme Ambrose DNP RN CCM – Chief Executive Officer

Jayme Ambrose, DNP, RN, CCM, is the visionary Founder and Chief Executive Officer of Adobe Population Health, an Arizona-based company offering an innovative, first-of-its-kind solution to the issue of health equity. Founded in 2018, Adobe employs a technology-driven model for interventional care management and takes a holistic approach to population health by closing care gaps, reducing costs, and caring for the whole person.

Armed with a Master of Science-Nursing from Arizona State University, Jayme was accepted into the Doctoral program for Nursing Science & Leadership at Case Western University. It was there, she developed an integrated case management model, as part of her doctoral thesis, with the objective of addressing the social determinants of health that often contribute to poor health outcomes for at-risk populations. After completing her doctorate in 2012, Beech Medical Group agreed to pilot her model, if Jayme agreed to accept a position as VP of Clinical Services. In 2016, she signed her first insurance company contract and initiated a holistic approach to case management for Medicare members. Her model integrates data analysis and risk assessment with a human touch to deliver proactive and preventative care that improves health outcomes, decreases hospital and ER visits, and reduces overall healthcare costs. In 2018, Beech Medical Group sold the company but not before giving Jayme the opportunity to purchase her division. On that day, Adobe was born with one mission: To positively impact the lives we touch.

As part of an innovative technology platform, Adobe utilizes proprietary risk stratification tools to identify the issues of those at greatest risk including food insecurities, financial hardships, transportation issues and even loneliness. And then through a proprietary and ground-breaking application called MASLOW™, members are invited to answer questions related to social determinants of health and then are connected to for-profit, non-profit, and governmental resources based on geolocation. To ensure impact, a qualified team member through a hybrid care model reaches out to offer assistance, closing the care loop. It is this human touch that sets Adobe apart from other case management organizations. Today, Adobe employs 300 nurses, nurse practitioners, social workers, support coordinators, dieticians, care navigators, and transition specialists and serves more than 200,000 elderly and underserved patients across three states.

Jayme has served on several boards including The Arizona Homecare Association, The American Association of Occupational Health Nurses and the Case Management Society of America where she is currently a member. She also currently serves on the PAC board of the Arizona Nurses Association. In addition, Jayme is currently adjunct professor for Arizona State University where she teaches RN to BSN and MSN students and develops curriculum.