Epidemiology of 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, current statistics indicate that 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. That risk profile, however, is not the only target group in danger of contracting osteoporosis, as it is a disease that does not discriminate on the basis of age or sex. The majority of its victims are in fact 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.

The formation of bone mass in human beings begins at conception and slowly builds through childhood and adolescence, peaking sometime near 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 deteriorate. Hereditary factors, as well as some outside influences like lifestyle, medical conditions and certain medications, generally determine the age and rate at which bone mass will begin to decline. That rate of decline becomes more significant the closer one gets to sixty years of age.

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. The NOF estimates that ten million Americans suffer from osteoporosis today. Of those ten million people, two million are men while eight million are women. Bone loss in men doesn’t generally begin as early as 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 deteriorate in men, it appears to take place at the same rate as that of the 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. One 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 their younger counterparts and may come with lifetime disability. It is predicted that as the population ages and lives longer lives, 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.