Do You Have Brittle Bones?

We all know that women have an increased risk of bone loss as they age. But what about men?

You may be surprised to know a significant proportion of men over age 65 have osteopenia, which is a process of bone loss.

What is Osteopenia?

Osteopenia is a condition in which bone mineral density (BMD) is lower than normal but not low enough to be diagnosed as osteoporosis. It is considered a precursor to osteoporosis, a more severe form of bone disease. 

Osteopenia often does not cause any symptoms. However, some people may experience: 

• Bone pain
• Fractures (especially in the spine, wrist, and hip)
• Height loss

How Many Senior Men Have Osteopenia?

In U.S. men over age 65, osteopenia affects approximately 30–47%, depending on diagnostic criteria and site measured.

Large, nationally representative studies using NHANES data report that among U.S. men aged 50 and older, the prevalence of osteopenia (low bone mineral density, T-score between -1.0 and -2.5) at the femoral neck is about 30%. Earlier analyses using different reference standards estimate a broader range, with 28–47% of men over 50 having osteopenia, depending on whether male or female reference values are used. While these studies focus on men 50+, the prevalence increases with age, so rates in men over 65 are likely at the higher end of this range.

A study of male hospital physicians aged 65+ found 58–66% had osteopenia, but this small, specific group may not represent the general population. International data and studies in other populations (e.g., China) also show osteopenia prevalence in older men ranging from 36–46%, supporting the U.S. estimates.

What Are the Risk Factors?

Key risk factors for osteopenia in men over 65 in the United States include advanced age, low body weight, low physical activity, smoking, excessive alcohol use, certain medications, chronic diseases, and hormonal changes.

Diagnosis of Bone Loss

Osteopenia is typically diagnosed using a bone density test, such as a dual-energy X-ray absorptiometry (DEXA) scan. The test measures BMD and compares it to the BMD of healthy people of the same age and gender. A T-score between -1.0 and -2.4 indicates osteopenia. 

Osteoporosis -- a more severe bone disease than osteopenia -- is present in about 5–6% of US men over 65 by standard national estimates, but may be as high as 18% or more in higher-risk or more thoroughly screened populations.

Most cases of osteopenia in men remain undiagnosed, highlighting a significant public health gap. In addition, up to 87% of men with osteoporosis are undiagnosed.

Treatment Options

Treatment for osteopenia aims to prevent further bone loss and reduce the risk of fractures. This may include: 

• Calcium and vitamin D supplements.
• Medications to increase bone density (e.g., bisphosphonates, raloxifene).
• Exercise, especially weight-bearing activities.
• Smoking cessation.
• Limiting alcohol intake.

Final Thoughts

Loss of bone density as we age is a known risk factor for men as we become older. It increases your risk of a bone fracture. Fractures can lead to long-term problems like chronic pain, loss of height (if the spine is affected), reduced mobility, and decreased independence. 

You probably have no idea what your bone density is. If so, don't you think it's time to find out, so that if you have osteopenia, you can do something to prevent it from getting worse? There are a number of facilities that offer DEXA scans in the Seattle area.

Even if you don't get a DEXA scan, you can think about increasing your weight-bearing exercise. A lot of us take easy walks and think that is enough. It probably isn't. A better choice is to do a combination of weight-bearing and muscle-strengthening activities, along with balance exercises to prevent falls.

If you're interested in nutritional supplements to support bone health, consult with an experienced health professional who fully understands the role of nutrition, such as a naturopathic doctor.

References

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