What is it called when your bone density decreases?

According to the CDC, over 43 million U.S. adults aged 50 and over had low bone mass, a precursor to osteoporosis, in 2017–2018. When your bone density decreases, it's typically diagnosed as either osteopenia or osteoporosis, depending on the severity of the loss. This silent process weakens the skeleton, increasing fracture risk and necessitating proactive care for healthy aging.

Quick Summary

The medical term for a decrease in bone density is osteopenia when the loss is mild to moderate, and osteoporosis when the bone loss is more severe, leading to porous and fragile bones. These conditions can leave bones more susceptible to fractures, especially in older adults. Diagnosis is based on a bone mineral density test, often a DEXA scan, to measure the extent of bone weakness.

Key Points

• Osteopenia and Osteoporosis: When your bone density decreases, it's called osteopenia (early stage, low bone mass) or osteoporosis (advanced stage, fragile bones).

• Silent Disease: Both conditions often lack noticeable symptoms until a fracture occurs, highlighting the importance of prevention and screening.

• Age and Gender Risks: Older age and being female, especially post-menopause, are major, non-modifiable risk factors for bone density loss.

• DEXA Scan Diagnosis: The condition is diagnosed using a DEXA scan, a specialized X-ray that measures bone mineral density with a T-score.

• Prevention Strategies: Key preventive measures include adequate calcium and vitamin D intake, regular weight-bearing exercise, and avoiding smoking and excessive alcohol.

• Treatment Options: Depending on the severity, treatment may involve lifestyle changes, supplements, and prescription medication to slow bone loss.

Understanding Bone Density Loss: Osteopenia and Osteoporosis

Bone density measures the mineral content in your bones, indicating their strength. Decreased bone density leads to weaker, more fragile bones and increases fracture risk. Osteopenia is an early stage of bone loss; osteoporosis is more severe, making bones porous and brittle.

The Silent Threat: Why Early Detection Matters

Bone density loss is often asymptomatic until a fracture occurs, earning it the nickname "silent disease". Understanding its causes and risks is vital for prevention, especially for senior health, to reduce the chance of complications.

What Causes Decreased Bone Density?

Bone mass typically peaks around age 30, after which loss outpaces formation. Various factors contribute to this decline.

Non-Modifiable Risk Factors

Factors like age, gender (women are more susceptible, especially postmenopause), race (Caucasian and Asian individuals have a higher risk), family history, and small body frame size increase risk and cannot be changed.

Modifiable Risk Factors

Lifestyle and health conditions you can influence include inadequate calcium and vitamin D intake, sedentary lifestyle, smoking, excessive alcohol consumption, and certain medications and medical conditions.

Diagnosing Bone Density Issues

A DEXA scan is the primary diagnostic tool, measuring bone mineral density, typically at the hip and spine, using low-dose X-rays. Results are given as a T-score: -1.0 or above is normal; -1.0 to -2.5 indicates osteopenia; -2.5 or lower signifies osteoporosis. Early testing is recommended for those with risk factors.

Prevention and Treatment

Managing osteopenia and osteoporosis involves slowing progression and reducing fracture risk through lifestyle adjustments and sometimes medication.

1. Diet: Consume enough calcium and vitamin D; supplements may be needed.
2. Exercise: Include weight-bearing and strength-training activities.
3. Lifestyle Changes: Quit smoking and reduce alcohol intake.
4. Medication: Doctors may prescribe drugs for osteoporosis or high-risk osteopenia.

Comparing Osteopenia and Osteoporosis

These conditions represent different points on the bone loss spectrum.

Feature	Osteopenia	Osteoporosis
Definition	Lower than normal peak bone mass.	Severely low bone mass, leading to porous and brittle bones.
Diagnosis	T-score between -1.0 and -2.5.	T-score of -2.5 or lower.
Fracture Risk	Increased risk, but lower than osteoporosis.	Significantly increased risk of fractures.
Progression	May or may not progress to osteoporosis.	Advanced stage of bone density loss.
Treatment Focus	Primarily lifestyle changes and monitoring.	Medication, lifestyle changes, and fall prevention.

The Path Forward: Living with Low Bone Density

Managing osteopenia or osteoporosis is possible with medical guidance, proper nutrition, exercise, and medication when needed, helping to maintain an active life and reduce fracture risk. For more information on bone health, visit the National Osteoporosis Foundation.

Frequently Asked Questions

Is it possible to improve bone density after a diagnosis of osteopenia?

Yes, it is possible to slow or even improve bone density with lifestyle changes. Regular weight-bearing exercise, adequate calcium and vitamin D intake, and stopping smoking can all help strengthen bones and prevent the progression to osteoporosis.

What is the difference between osteopenia and osteoporosis?

Osteopenia is the precursor to osteoporosis, representing a mild to moderate decrease in bone density. Osteoporosis is the more severe stage, where bones are porous and highly susceptible to fractures.

What are the early signs of decreased bone density?

There are often no early signs. Bone density loss is a 'silent disease' until a fracture occurs. For this reason, screening with a DEXA scan is crucial for those at risk.

Can men get osteoporosis?

Yes, while women are at higher risk, men can also develop osteoporosis. In the U.S., about 2 million men aged 50 and over are estimated to have the condition.

What types of exercise are best for preventing bone loss?

Weight-bearing exercises, such as walking, jogging, dancing, and climbing stairs, along with strength-training exercises, are most effective for building bone mass.

At what age should people start getting checked for bone density loss?

Routine bone density screening is often recommended for women aged 65 and older, and for men and younger women with specific risk factors. You should discuss your personal risk factors with your doctor to determine the right time for you.

Are there medications to treat decreased bone density?

Yes, for diagnosed osteoporosis, and sometimes for osteopenia, doctors may prescribe medications like bisphosphonates to help slow or prevent bone loss and strengthen the skeleton.