Osteoporosis is a disease marked by reduced bone strength leading to an increased risk of fractures, or broken bones. Bone strength has two main features: bone mass (amount of bone) and bone quality. Osteoporosis is the major underlying cause of fractures in postmenopausal women and the elderly. Fractures occur most often in bones of the hip, spine, and wrist, but any bone can be affected. Some fractures can be permanently disabling, especially when they occur in the hip.

In the United States today, an estimated 10 million people over age 50 have osteoporosis and almost 34 million have low bone mass that puts them at increased risk for developing the disease. Four out of five people who have osteoporosis are women, but about 2 million men in the U.S. also have the disease and 14 million more have low bone mass that puts them at risk for it. One in two women and as many as one in four men over age 50 will have an osteoporosis-related fracture in their lifetime. Osteoporosis can strike at any age, although the risk of developing the disease increases as you get older. In the future, more people will be at risk of developing osteoporosis because people are living longer and the number of elderly people in the population is increasing. Another 34 million have a preliminary condition called osteopenia (low bone mass), which puts them at increased risk for developing osteoporosis.

Osteoporosis is often called the “silent disease” because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a fracture or a vertebra to collapse. Currently there is no accurate measure of overall bone strength. Bone mineral density (BMD) is frequently used as a proxy measure and accounts for approximately 70 percent of bone strength. The World Health Organization (WHO) operationally defines osteoporosis as bone density 2.5 standard deviations below the mean for young white adult women. It is not clear how to apply this diagnostic criterion to men, children, and across ethnic groups. Because of the difficulty in accurate measurement and standardization between instruments and sites, controversy exists among experts regarding the continued use of this diagnostic criterion.

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