Osteoporosis is a significant medical and public health concern for postmenopausal women. Estrogen levels decrease sharply once a women reaches menopause, which influences bone loss.
7 In 2010, an estimated 2.0 million men and 8.2 million women aged 50 years or older had osteoporosis.
8 That number is estimated to rise to 10.2 million women and 3.3 million men in 2020.
9 About 30% of osteoporotic hip fractures occur in men older than 50 years.
10 In Norway, the Tromsø study
11 showed that BMD declined with age in men and women, yet this decline occurred to a greater degree in women. Older men (aged >60 years) have a higher mortality rate resulting from hip fractures than older women (aged >60 years) with similar fractures.
12 However, adults aged 35 years or younger and early–middle-aged men and women (defined in the current study as ages 35-50 years) are also at risk for osteoporosis and osteopenia, which is a BMD decline of less severity than osteoporosis, defined as 1.1 to 2.5 SD below the mean at the femoral neck or total femur.
3 Yet, the early–middle-aged population is a widely understudied group in terms of osteoporosis and BMD research. One prospective population-based study of 33,000 men and women aged 27 to 61 years found an association of osteopenia and osteoporosis with fragility fractures.
13 However, few data predict the risk factors for osteopenia and osteoporosis in this population. The modifiable risk factors for osteopenia and osteoporosis in adults aged 60 years or older are immobility (lack of physical activity/exercise), low body mass index (BMI), use of steroids, smoking, excessive alcohol drinking, low calcium consumption, low sunlight exposure, and use of antidepressants and antacids.
4,14,15 Age, gender, and race are well-established nonmodifiable risk factors.