What is Osteoporosis?

Osteoporosis is a disease in which bones become less dense, lose strength, and are more likely to break. Some people describe bones with osteoporosis as “Swiss cheese.” Even the word, osteoporosis, is derived from the Greek osteo, meaning bones, and porosis, with holes. It has been defined as “a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture” (NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy, 2001).

Osteoporosis happens mainly to women at midlife and later, but also can happen to men and children. In children, new bone forms more quickly than it breaks down so that bone is actually growing all the time. In adults, bone goes through a constant and normal process where new bone is formed and old bone is broken down simultaneously and at relatively even rates. When more bone is lost than is being formed, osteoporosis develop.

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Osteoporosis, or bone loss, occurs when the process of bone breakdown and bone formation gets out of balance. The cells that cause bone breakdown (osteoclasts) start to make canals and holes in the bone faster than the cells that cause bone formation (osteoblasts) can make new bone to fill in the holes. The bone becomes fragile and more likely to break. When bone has to give up some of its calcium to ensure that blood levels of calcium stay normal, bone is weakened by the loss of calcium. The weakening of bone by its loss of calcium also leads to osteoporosis.

Osteoporosis is one of the leading causes of morbidity and mortality amongst the elderly. With the prediction that the number of people who are 60 years or more will increase from  approximately 300 million to greater than 700 million in the next 25 years, it can be appreciated that osteoporosis will rapidly reach epidemic proportions. This will not only represent a huge health care cost but also compromise the physical well-being and quality of life of a substantial segment of the world’s population. Current estimates indicate that osteoporosis is an expensive health care problem, costing Americans $18 billion per year.

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Osteoporosis can result in disability and social isolation. Fractures that result from osteoporosis can be devastating. Up to 20% of those who fracture a hip will die within one year of the fracture. Of those who survive, 50% will not be able to return to independent living. Those who suffer fractures as a result of osteoporosis may not be able to dress themselves or carry on other activities of daily living, frequently causing depression and isolation from others. About 20% will need nursing home or assisted living care after a hip fracture because they are not able to live independently.

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