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Osteoporosis, which literally means "porous bones," is the most common bone disease in the world.¹ A "silent disease," it can progress without obvious symptoms but eventually results in fractures which can cause severe pain, deformity, disability, hospitalization-even death.

The disease is characterized by low bone mass and deterioration of bone structure that puts patients at risk for fractures.³ Fractures can lead to other illnesses, loss of independence, possible institutionalization and even death. ² Following a fracture, depression and anxiety are common, and quality of life is affected due to fears about additional fractures, mobility limitations and possible deformity. ³ Although everyone experiences some bone loss with aging, osteoporosis and its fractures are not a natural part of aging.

Today, more than 44 million Americans over the age of 50 are affected by or at risk for osteoporosis and it will likely affect millions more as the U.S. population ages. In fact, it is considered so significant and prevalent a public health issue that the U.S. Surgeon General issued the first ever report on bone health and osteoporosis in October 2004, putting it on par with smoking and obesity as a major public health threat.¹

How Osteoporosis Develops
Bone is living, growing tissue that is constantly being broken down and replaced by new bone in a continuous and lifelong process called bone remodeling. In young people, new bone is created faster than it is broken down, so bone increases in density and strength until the process peaks at around age 30. The process then gradually reverses and bone begins breaking down faster than it is replaced. In women, the rate of bone loss is most rapid in the first few years following menopause, when the ovaries stop producing estrogen, a hormone that helps protect against bone loss.

Osteoporosis Causes and Risk Factors
Osteoporosis is a complex disease, and not all of its causes are known. Certain factors are associated with an increased risk for the disease, including:

• Being female
• Advanced age
• Estrogen deficiency (e.g., following menopause in women)
• Personal history of fracture as an adult
• Caucasian race (however, people from all ethnic groups suffer from osteoporosis)
• Low body weight and body mass index
• Family history of osteoporosis
• Smoking
• Low testosterone in men

Screening and Diagnosis
The best way to determine whether someone is at risk for, or already has, osteoporosis is with a bone mineral density (BMD) test.⁴ A BMD test can: detect low bone density before a fracture occurs or confirm low bone density following a fracture; predict the risk of a future fracture; determine the rate of bone loss; and monitor the effects of treatment (if tests are repeated once a year or more).

BMD tests cannot stand alone; they should always be part of a complete medical workup supervised by a knowledgeable physician. However, a BMD test is the recommended way to detect low bone density and predict the chances of fracturing a bone in the future.⁵

Osteoporosis and low bone mass are preventable and treatable, click here for tips on how to maintain strong bones. Additional information about steps that patients can take to protect against osteoporosis is available at www.BoneBalance.org.

1. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General; 2004.
2. Doherty DA, Sanders KM, Kotowicz MA, Prince, RL, Lifetime and Five-Year Age-Specific Risks of First and Subsequent Osteoporotic Fractures in Postmenopausal Women. Osteoporosis International: 2001: 12:16-23. (this is not one of the endnotes listed)
3. America's Bone Health: The State of Osteoporosis and Low Bone Mass in Our Nation: The National Osteoporosis Foundation; February 2002.
4. Riggs BL, Kholsa S, Melton LJ, Sex Steroids and the Construction and Configuration of the Adult Skeleton. Endocrine Reviews: June 2002: 23 (3): 279-302.
5. National Institutes of Health Consensus Development Panel on Osteoporosis: Osteoporosis prevention, diagnosis, and therapy. JAMA. Feb 14 2001;285(6):785-795.
Doherty DA, Sanders KM, Kotowicz MA, Prince, RL, Lifetime and Five-Year Age-Specific Risks of First and Subsequent Osteoporotic Fractures in Postmenopausal Women. Osteoporosis International: 2001: 12:16-23. (this is not one of the endnotes listed)