Epidemiology of Osteoporosis

The Surgeon General estimates 1.5 million Americans suffer a fracture due to bone disease every year. Most of these fractures are in people with osteoporosis. About a third result in hospitalization. Fractures are often the trigger that results in people going into nursing homes. It’s estimated that 180,000 people go into nursing homes soon after a fracture every year.

Experts project 40% of women over age 50 will experience a bone fracture at some point in their lifetimes. The US Agency for Healthcare Research and Quality says 52 million people in the US have low bone density - although most of these do not have osteoporosis.

According to the National Osteoporosis Foundation and the National Institutes of Health, if you are a white or Asian woman over fifty, are small in stature and slight in build, are taking certain medications, or have a family history of osteoporosis, you are the most likely to be one of the estimated ten million Americans today that have osteoporosis. If poor nutrition, prolonged inactivity, smoking, or excessive alcohol consumption are added to that list, your chances for contracting osteoporosis increase. The majority of osteoporosis patients victims are postmenopausal women, but men and children are not beyond its reach. In America, 55 percent of people over fifty, or roughly 44 million Americans are threatened by osteoporosis, says the NOF. Most of these do not actually have osteoporosis, but may have a lower than average bone density.

The formation of bone mass begins in utero and builds through childhood and adolescence, peaking sometime in the twenties. According to the NOF, 85 to 90 percent of peak bone mass forms by the age of 18 in females and by the age of 20 in males. With adequate nutrition and absent degenerative disease, healthy bone mass should form consistently and provide stability well through young adulthood and beyond. At some point as age progresses however, the density of bone will slowly begin to decline. Hereditary factors, as well as influences like lifestyle, medical conditions, and certain medications, determine the age and rate at which bone mass decreases.

Anything that interrupts the formation of healthy bone structure in a child, adolescent or young adult can lead to a predisposition for osteoporosis. Although rare, osteoporosis is found in young people, but is usually caused by a separate, underlying medical condition or the medication prescribed to treat that condition, as may be the case in juvenile rheumatoid arthritis, diabetes or kidney disease.

Men are susceptible to osteoporosis, too, although not at the same statistical rate as women. Of the ten million people Americans who suffer from osteoporosis today, two million are men. Bone loss in men generally begins later than it does in women with their bone density beginning to decline in their sixties or seventies instead of their fifties. But once bone mass does begin to decline in men, it appears to take place at the same rate as for women. Osteoporosis is often not diagnosed as readily in men as it is in women because its lower incidence has lead to less frequent medical screening. The first indication of osteoporosis in older men is usually a fracture.

Known also as "the silent disease," osteoporosis and its symptoms are undetectable. The patient cannot feel the deterioration of bone mass; fractures often serve as the first confirming diagnosis. Outcomes following fracture in the elderly are much less optimistic than for their younger counterparts and may come with lifetime disability. It is predicted that as the population ages, the incidence of osteoporosis in the United States and throughout the world will grow tremendously, making effective screening, diagnosis and prevention even more urgent. Widespread screening is not done, in part due to cost and questions regarding the efficacy of a broad population screening policy.

Sources for information on page: Fox News, AHRQ.gov, Centers for Disease Control

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Protect Your Bones

1) Exercise (ideally including some resistance exercise to build strength.)

2) Eat a healthy diet. Pay special attention to your daily requirement for Vitamin D and calcium.

3) Don't smoke and avoid excessive alcohol.

4) Follow your doctor's advice and get bone density tests as he or she suggests.

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