What is the disease that decreases bone mass?

According to the National Institute on Aging, about one in five women over age 50 and one in 20 men suffer from osteoporosis. This bone-thinning condition is the primary disease that decreases bone mass, leading to a higher risk of fractures and other health complications.

Quick Summary

Osteoporosis is the disease that causes bones to become porous, weak, and brittle due to a decrease in bone mineral density and mass, increasing the risk of fractures. It is often called a "silent disease" because symptoms may not appear until a bone is broken.

Key Points

• Osteoporosis Defined: Osteoporosis is a disease that causes bones to become weak and brittle due to a decrease in bone mass and density.

• The "Silent Disease": Early stages often have no symptoms, with the first sign often being a fracture from a minor fall or stress.

• Osteopenia is a Precursor: Low bone density, or osteopenia, is an early warning sign that can progress to osteoporosis if left unmanaged.

• Diagnosis with DEXA Scan: Diagnosis relies on a bone mineral density (BMD) test, typically a DEXA scan, which measures bone density and assigns a T-score.

• Risk Factors Vary: Factors like age, sex (postmenopausal women are at higher risk), genetics, and low calcium/vitamin D intake contribute to risk.

• Treatment is Comprehensive: Management includes lifestyle changes like diet and exercise, medications, and fall prevention to minimize fracture risk.

Understanding Osteoporosis and its Causes

Osteoporosis is a widespread condition affecting millions, especially older adults. In a healthy body, bones are living tissue that is constantly being remodeled, with old bone being broken down and new bone being created. Osteoporosis occurs when the creation of new bone doesn't keep up with the removal of old bone, causing the internal, honeycomb-like structure of the bones to become more porous. This weakens the bones, making them more fragile and susceptible to breaks from minor falls, and in severe cases, even from a simple cough or sneeze.

There are several key factors contributing to the development of osteoporosis:

• Aging: As people get older, bone mass is naturally lost faster than it is created. Peak bone mass is typically reached around age 30, and the decline begins shortly after.
• Hormonal changes: A major factor for women is the sharp drop in estrogen levels after menopause, which accelerates bone loss. Men also experience a decline in testosterone with age, which can weaken bones.
• Genetics: A family history of osteoporosis, particularly a parent with a hip fracture, increases your risk.
• Dietary factors: A lifelong low intake of calcium and vitamin D can contribute to lower bone density. Calcium is essential for building strong bones, while vitamin D is crucial for calcium absorption.
• Lifestyle choices: A sedentary lifestyle, smoking, and excessive alcohol consumption have all been linked to weakened bones.
• Medical conditions and medications: Certain health issues, like thyroid problems, and long-term use of specific medications, such as corticosteroids, can increase your risk.

The Progression from Osteopenia to Osteoporosis

Osteopenia is a precursor to osteoporosis and represents an early stage of bone density loss. It is defined as a lower-than-normal bone mineral density (BMD), but not yet low enough to be diagnosed as osteoporosis. Many people with osteopenia do not experience any symptoms, and a diagnosis is typically made through a bone density test. While not everyone with osteopenia will progress to osteoporosis, it serves as an important warning sign that bone health needs attention. With lifestyle adjustments and sometimes medication, it's possible to slow or even reverse bone loss and prevent the onset of the more severe condition.

Diagnosis and Screening

Diagnosing osteoporosis involves a painless procedure called a dual-energy X-ray absorptiometry (DEXA) scan. This scan measures the bone mineral density (BMD), typically at the hip and spine. The results are reported as a T-score:

• Normal: T-score of -1.0 or higher.
• Osteopenia: T-score between -1.0 and -2.5.
• Osteoporosis: T-score of -2.5 or lower.

Regular screening is recommended for certain individuals. For instance, the U.S. Preventive Services Task Force suggests screening for all women 65 and older and for younger women with increased risk factors. Men may also be screened, often beginning around age 70 or earlier if they have significant risk factors.

Treatment Options for Osteoporosis

The goal of treatment is to slow or stop bone loss and prevent fractures. Treatment plans are personalized and can include:

1. Lifestyle Modifications: Incorporating adequate calcium and vitamin D, engaging in weight-bearing and resistance exercises, quitting smoking, and limiting alcohol intake are foundational steps.
2. Medication: A variety of drugs are available to manage osteoporosis. Some, like bisphosphonates, slow down the rate of bone loss, while others, like parathyroid hormone analogs, stimulate new bone formation.
3. Fall Prevention: Reducing the risk of falls is critical for those with weakened bones. This includes simple home safety measures like removing tripping hazards and installing handrails.

Comparison of Osteopenia vs. Osteoporosis

Feature	Osteopenia	Osteoporosis
Severity	Early stage of bone density loss.	More advanced, severe bone density loss.
T-Score (BMD)	Between -1.0 and -2.5.	-2.5 or lower.
Bone Structure	Bone density is lower than normal, but not as porous.	Bones are significantly more porous and brittle.
Fracture Risk	Increased risk of fracture compared to normal bone density.	Significantly higher risk of fracture, even from minor events.
Symptoms	Often asymptomatic. Diagnosed via bone density screening.	Often asymptomatic until a fracture occurs.
Prognosis	Can often be managed or reversed with lifestyle changes.	A chronic, progressive disease requiring ongoing management.

Conclusion: Taking Control of Your Bone Health

Osteoporosis is the disease that decreases bone mass, but its serious consequences—particularly fractures—are not an inevitable part of aging. Understanding the risk factors, recognizing the role of osteopenia as a precursor, and being proactive with screening and treatment are crucial. By adopting a healthy lifestyle rich in calcium and vitamin D and incorporating regular weight-bearing exercise, you can build and maintain strong bones. For those with a diagnosis, effective medical treatments and fall prevention strategies are available to manage the condition and protect your quality of life. Empower yourself with knowledge and work with your healthcare provider to create a personalized plan for lifelong bone health.

For further reading on bone health guidelines and recommendations, visit the Bone Health and Osteoporosis Foundation.

Frequently Asked Questions

What is the main disease that decreases bone mass?

The main disease is osteoporosis, a condition that makes bones weak and brittle, leading to an increased risk of fractures.

How is osteoporosis different from osteopenia?

Osteopenia is a less severe stage of bone density loss, while osteoporosis is the more advanced stage. Osteopenia can progress into osteoporosis if not managed.

How is osteoporosis diagnosed?

Osteoporosis is diagnosed using a bone mineral density (BMD) test, most commonly a dual-energy X-ray absorptiometry (DEXA) scan, which measures bone density at the hip and spine.

What are the early signs of osteoporosis?

Osteoporosis is often called a "silent disease" because it typically has no early symptoms. Many people don't know they have it until they experience a fracture.

What can I do to prevent bone mass from decreasing?

To help prevent bone mass decrease, you should consume enough calcium and vitamin D, do weight-bearing exercises, avoid smoking and excessive alcohol, and take precautions to prevent falls.

Are older men at risk for osteoporosis?

Yes, while osteoporosis is more common in women, men are also at risk. By age 65 or 70, men and women lose bone mass at the same rate, and older men are at increased risk of fracture.

What kind of exercise is best for bone health?

Weight-bearing exercises, where you work against gravity, are best for building bone strength. Examples include walking, jogging, dancing, and lifting weights.