Human bone mass normally decreases from its adult peak with advancing age. This is especially so in women after the menopause, since post-menopausal oestrogen deficiency triggers the activity of the osteoclasts, the cells responsible for bone resorption, thereby causing an acceleration of bone remodelling. Osteoporosis is an avoidable skeletal condition characterized by low bone mass and micro-architectural deterioration of bone tissue, leading to an increased risk of fracture. While the lifetime risk of osteoporosis for a 50-year-old man it is one in five, for a 50-year-old woman it is estimated at one in two.
Prevention of osteoporosis can be:
1. Primary, which involves preventing bone loss from occurring,
2. Secondary in which the progression of bone loss is inhibited to avert the development of fractures, or
3. Tertiary in which patients with existing fractures are treated to prevent subsequent fracture
Although osteoporosis is relatively common, the diagnosis is often not made until after a fracture has occurred, so there is a good case for osteoporosis screening. Nutritional status is of key importance and is currently a major health issue, since many osteoporosis sufferers are introduced to anti-resorptive treatment without adequate prior nutritional assessments - which must limit the value of such treatments.
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