Involutional (Physiologic) Bone Loss in Women and the Feasibility of Preventing Structural Failure*

Abstract

ABSTRACT: One of the most remarkable manifestations of the normal aging process is loss of bone after age 45–50 in apparently normal women. The magnitude of this loss is such that after the age of 80 virtually all women have bone masses that are smaller than those of normal women before the age of 45, i.e., the two populations with respect to bone mass are entirely different. The relationship of such “physiologic” bone loss to structural failure (vertebral compressions, fractured femoral necks) is discussed by comparing the radiologically measured bone mineral mass in the proximal radius in normal women throughout the adult age range with that in a group of 71 women with vertebral compressions and 36 women with femoral‐neck fractures. At a time of life when the incidence of structural failure is still low, a critical range of bone mass can be defined in which the abnormality (bone loss) is clearly recognized in the radius. The prevention of further bone loss at this stage should markedly lower the incidence of both the “crushed vertebrae syndrome” and femoral‐neck fracture. This approach is particularly appropriate for those geriatric female patients who still enjoy active life, including sports and travel.