Osteopenia

Osteopenia, known as "low bone mass" or "low bone density", is a condition in which bone mineral density is low.^[1] Because their bones are weaker, people with osteopenia may have a higher risk of fractures, and some people may go on to develop osteoporosis.^[2] In 2010, 43 million older adults in the US had osteopenia.^[3] Unlike osteoporosis, osteopenia does not usually cause symptoms, and losing bone density in itself does not cause pain.

There is no single cause for osteopenia, although there are several risk factors, including modifiable (behavioral, including dietary and use of certain drugs) and non-modifiable (for instance, loss of bone mass with age). For people with risk factors, screening via a DXA scanner may help to detect the development and progression of low bone density. Prevention of low bone density may begin early in life and includes a healthy diet and weight-bearing exercise, as well as avoidance of tobacco and alcohol. The treatment of osteopenia is controversial: non-pharmaceutical treatment involves preserving existing bone mass via healthy behaviors (dietary modification, weight-bearing exercise, avoidance or cessation of smoking or heavy alcohol use). Pharmaceutical treatment for osteopenia, including bisphosphonates and other medications, may be considered in certain cases but is not without risks. Overall, treatment decisions should be guided by considering each patient's constellation of risk factors for fractures.