The Facts:

• In the United States, 10 million people already have osteoporosis; 80 percent are women.
• One out of every two women and one out of every four men will have an osteoporosis-related fracture in their lifetime.

Osteoporosis is a disease that thins and weakens the bones so they become very fragile and break easily. Like high blood pressure or hypertension, osteoporosis is often “silent” because bone loss occurs without symptoms. People do not know they have osteoporosis until a sudden strain, bump, or fall causes a bone to break.

Bone mass stops increasing around the age of 30.  The goal for preventing osteoporosis is to maintain as much bone as possible for as long as you can. For most women, bone loss continues to increase several years after menopause and for men, bone loss occurs more slowly.

Risk Factors for Osteoporosis:

• Gender. Women are at a higher risk for osteoporosis than men because they have smaller bones; they also lose bone density more rapidly than men because of the changes that happen after menopause.
• Age. Osteoporosis is a disease that progresses with age, because more bone is broken down than it is replaced.
• Ethnicity. Caucasian and Asian women are at a higher risk for osteoporosis due to lower bone mass and density compared with other ethnic groups.
• Family history. Osteoporosis tends to run in families; if a family member has it or breaks a bone, there is a greater chance you will as well.
• History of previous fracture.  People who have had a fracture are at high risk of having another are at increased risk.

Bone Density Testing Guidelines: 

The test used to diagnose osteoporosis is called a bone density test.  What bone density tests do is compare your bone density to the bones of an average, healthy young adult. The test results are called T-scores and these tell you how strong your bones are, whether you have low bone mass or are at risk for having a fracture, and whether you have osteoporosis. Bone density tests measure the strength of the hip, spine, and/or wrist, which are the bones that would break most often with people with osteoporosis.

The decision to have a bone density test should be based on an individual's risk profile, and testing is never suggested unless the results could influence a treatment decision. The National Osteoporosis Foundation's (NOF) Physicians Guide to Prevention and Treatment of Osteoporosis advises that a bone mineral density test should be performed on:

• All women aged 65 and older regardless of their risk profile;
• Younger postmenopausal women with one or more risk factors (other than being white, postmenopausal and female);
• Postmenopausal women who presently have fractures (to confirm the diagnosis and determine disease severity); and
• Men age 60 and over.

Preventing Osteoporosis:

One of the best ways to prevent osteoporosis is consuming a diet that is rich in calcium and adequate in vitamin D, participating in a regular exercise program, and preventing falls. The information provided by abone density test can help your health care provider determine which prevention or treatment options are right for you.

World Health Organization Definitions of Osteoporosis Based on Bone Density Levels:

• Normal. Bone Density is within 1 SD (standard deviation) (+1 or -1) of the young adult mean;
• Low Bone Mass. Bone density is 1 to 2.5 SD (standard deviations) below the young adult mean (-1 to -2.5 SD);
• Osteoporosis. Bone density is 2.5 SD (standard deviations) or more below the young adult mean (> -2.5 SD); and
• Severe (established) osteoporosis. Bone density is more than 2.5 SD (standard deviations) below the young adult mean and there has been one or more osteoporotic fractures.

Sources:  National Institute of Arthritis and Musculoskeletal and Skin Diseases; National Osteoporosis Foundation.