Probability of Developing Osteoporosis

Osteoporosis affects approximately 12.5% of Americans over age 50, with an additional 43% having low bone density (osteopenia). Women are far more affected, with about 19% of women over 50 having osteoporosis compared to about 4% of men. The lifetime risk of an osteoporotic fracture for a woman is approximately 50%, compared to 25% for a man.

Risk factors include female sex, advancing age, menopause (the sharp drop in estrogen accelerates bone loss), low body weight, family history, smoking, excessive alcohol use, low calcium and vitamin D intake, sedentary lifestyle, and certain medications (long-term corticosteroid use). White and Asian women are at highest risk.

Osteoporosis is often called a "silent disease" because bone loss occurs without symptoms until a fracture happens. Hip fractures are the most serious consequence, with a 20% mortality rate within one year in older adults. Prevention includes adequate calcium and vitamin D intake, weight-bearing exercise, fall prevention, and bone density screening (DEXA scan) for women over 65 and high-risk individuals. Treatments include bisphosphonates, denosumab, and anabolic agents like teriparatide.