What percent of this older population has osteoporosis? An in-depth look

According to the CDC's 2017–2018 data, the age-adjusted prevalence of osteoporosis among U.S. adults aged 50 and over was 12.6%, yet this figure varies significantly by demographic factors. Understanding what percent of this older population has osteoporosis requires a closer examination of the data, including differences across age groups and gender.

Quick Summary

Based on 2017–2018 data from the CDC, 12.6% of U.S. adults aged 50 and older have osteoporosis. This prevalence is significantly higher in women (19.6%) compared to men (4.4%) and rises with age, with nearly 18% of those 65 and older affected.

Key Points

• Prevalence Varies: For U.S. adults aged 50 and over, the age-adjusted prevalence of osteoporosis is 12.6%, according to CDC 2017-2018 data.

• Gender and Age Disparities: Women are more affected, especially after age 65, with 27.1% of women in this age bracket having osteoporosis, compared to 5.7% of men.

• Low Bone Mass is Common: A large portion of the older population, 43.1% of adults 50 and over, has low bone mass (osteopenia), which increases fracture risk.

• Multiple Risk Factors Exist: Beyond age, gender, and genetics, modifiable risk factors include diet, exercise levels, smoking, and alcohol intake.

• Prevention is Key: Strategies like a calcium/vitamin D rich diet, weight-bearing exercise, and regular DEXA screenings are crucial for prevention and management.

Prevalence of Osteoporosis in the Older Population

Prevalence rates for osteoporosis differ based on the specific age bracket, with the risk increasing substantially as individuals get older. The Centers for Disease Control and Prevention (CDC) provides some of the most reliable data on this condition in the United States, based on the National Health and Nutrition Examination Survey (NHANES).

United States Statistics (CDC, 2017–2018)

For U.S. adults aged 50 and over, the age-adjusted prevalence of osteoporosis was 12.6%. This number represents those with osteoporosis at either the femur neck, the lumbar spine, or both. Looking at the breakdown by gender and age group reveals more specific trends:

• Adults 50 and over: The overall prevalence was 12.6%, with a notable disparity between the sexes: 19.6% for women versus 4.4% for men.
• Adults 65 and over: As age increases, so does the prevalence. For those aged 65 and over, the prevalence rose to 17.7%.
• Women 65 and over: Women are at a particularly high risk. The prevalence for women in this age group was 27.1%, which is significantly higher than their male counterparts.

Global and Other U.S. Context

It is also beneficial to consider broader data. A 2021 meta-analysis examining global prevalence reported that the overall rate of osteoporosis among elders worldwide was 21.7%. This also showed a significant gender difference, with prevalence reported at 35.3% in older women and 12.5% in older men. The figures highlight that osteoporosis is a widespread issue affecting aging populations globally.

The Importance of Addressing Low Bone Mass

In addition to full-blown osteoporosis, many older adults have low bone mass, also known as osteopenia. This condition is a precursor to osteoporosis and greatly increases the risk of fracture. According to the same CDC 2017–2018 data:

• 43.1% of U.S. adults aged 50 and over had low bone mass.
• Again, women were more affected, with 51.5% experiencing low bone mass compared to 33.5% of men.

Key Risk Factors for Osteoporosis in Seniors

While advanced age is a primary risk factor, other elements contribute to an individual's susceptibility to osteoporosis. These include both uncontrollable factors and modifiable lifestyle choices.

Uncontrollable Risk Factors

• Gender: Women, particularly postmenopausal women, are at a much higher risk than men due to the rapid decline in estrogen, which is crucial for bone protection.
• Age: Bone density naturally declines with age, increasing the risk of osteoporosis and fractures.
• Race/Ethnicity: White and Asian individuals are at the highest risk, though the disease affects all races.
• Family History: Having a parent or sibling with osteoporosis increases your risk.
• Body Frame Size: Individuals with smaller body frames have less bone mass to begin with, making them more vulnerable as they age.

Modifiable and Other Risk Factors

• Dietary Deficiencies: A lifelong lack of calcium and vitamin D can weaken bones and increase fracture risk.
• Sedentary Lifestyle: A lack of weight-bearing exercise contributes to a higher risk of low bone density. Weight-bearing activities help stimulate bone growth and strength.
• Excessive Alcohol Use: Chronic, heavy alcohol consumption is linked to weaker bones and an increased risk of falls.
• Tobacco Use: Smoking has been shown to contribute to reduced bone density.
• Certain Medications: Long-term use of specific drugs, such as corticosteroids, can interfere with bone rebuilding.
• Medical Conditions: Some diseases, including rheumatoid arthritis, certain cancers, and endocrine disorders, can increase the risk of osteoporosis.

Comparison of Osteoporosis and Osteopenia

Understanding the difference between low bone mass (osteopenia) and osteoporosis is important for prevention and treatment. Bone mineral density (BMD) is measured using a DEXA scan, with results categorized by a T-score.

Feature	Osteopenia (Low Bone Mass)	Osteoporosis
T-Score	Between -1.0 and -2.5	-2.5 or lower
Condition	Bone density is lower than normal, but not yet severe enough to be classified as osteoporosis.	Bone density is severely low, and the bone structure is compromised.
Fracture Risk	Increased risk of fracture compared to someone with normal bone density, but lower than with osteoporosis.	Significantly higher risk of fracture from minor falls or everyday activities.
Action	Can often be managed with lifestyle changes, such as dietary adjustments and weight-bearing exercise. Medications may be considered depending on overall fracture risk.	Typically requires medication to reduce fracture risk, in addition to lifestyle modifications.

Strategies for Preventing and Managing Osteoporosis

Combating osteoporosis requires a multi-pronged approach that focuses on prevention, early detection, and effective management. Seniors, and those at risk, should prioritize the following actions:

1. Maintain a Calcium and Vitamin D Rich Diet: Ensure adequate intake of both nutrients, either through diet (leafy greens, dairy, fatty fish) or supplements. Vitamin D is essential for calcium absorption.
2. Engage in Regular Weight-Bearing Exercise: Activities like walking, jogging, dancing, and weightlifting are proven to help build and maintain bone density. Aim for at least 30 minutes of weight-bearing exercise most days of the week.
3. Get Screened: Women over 65 and men over 70 should undergo routine bone mineral density screenings (DEXA scans). Earlier screening is recommended for those with increased risk factors.
4. Discuss Medication Options: For those diagnosed with osteoporosis, several medications are available that can either build bone or slow bone loss. Your doctor can help determine the best course of action.
5. Address Fall Prevention: Since fractures are the primary concern with osteoporosis, taking steps to prevent falls is critical. This includes managing medications, ensuring well-lit hallways, and removing trip hazards.
6. Avoid Smoking and Limit Alcohol: Both smoking and excessive alcohol consumption are detrimental to bone health and should be avoided.

The Silent Disease: A Call to Action

Often called a 'silent disease,' osteoporosis can progress for years without symptoms until a fracture occurs. The high prevalence rates among older adults, especially women, underscore the importance of being proactive about bone health. By understanding the risk factors and taking preventative steps, older adults can significantly reduce their risk of devastating fractures and maintain their quality of life.

For more information on bone health, visit the Bone Health & Osteoporosis Foundation.

Frequently Asked Questions

What age group is included in the 'older population' for osteoporosis statistics?

Older population is often defined as adults aged 50 and over, as well as those 65 and over, depending on the report. Many studies focus on these age brackets because the prevalence of osteoporosis increases with age, and risk factors become more significant.

Does osteoporosis affect men and women equally?

No, osteoporosis is significantly more common in women, especially postmenopause, due to the sharp decline in estrogen. For example, the CDC reported that in 2017-2018, nearly 20% of women aged 50+ had osteoporosis, compared to just over 4% of men in the same age group.

What is the difference between osteoporosis and osteopenia?

Osteopenia is a condition of low bone mass that precedes osteoporosis. While both increase the risk of fracture, osteoporosis involves a more severe loss of bone density and greater structural weakening. A DEXA scan measures bone mineral density to determine which condition an individual has.

What are the early signs of osteoporosis?

Osteoporosis is often called a 'silent disease' because it typically has no symptoms until a bone breaks. Sometimes, a first sign can be back pain caused by a spinal compression fracture, or a loss of height and stooped posture over time.

What kind of exercises can help with bone health?

Weight-bearing exercises, where your body works against gravity, are best for bone health. Examples include walking, jogging, dancing, stair climbing, and strength training with weights or resistance bands. Regular activity helps maintain bone density and improve balance.

When should I get screened for osteoporosis?

The U.S. Preventive Services Task Force recommends routine DEXA screening for women starting at age 65. For men, screening is generally recommended at age 70, but earlier screening may be advised for both men and women with specific risk factors for low bone density.

Can diet help prevent osteoporosis?

Yes, a diet rich in calcium and vitamin D is essential for maintaining strong bones. Good sources include low-fat dairy products, leafy green vegetables, and fortified foods. In addition, some people may require supplements to meet their daily needs.