Osteoporos

Osteoporosis, sometimes written osteoporos in some languages, is a bone disease characterized by reduced bone mass and deterioration of bone tissue, leading to fragility and an increased risk of fractures.

The condition often develops without symptoms until a fracture occurs, most commonly in the hip, spine or wrist. Bones become porous and can break more easily from minor trauma or even normal daily activities. Fractures associated with osteoporosis can lead to disability, reduced mobility and, in some cases, long-term dependence.

Risk factors include advancing age and female sex, especially after menopause, as well as a family history, low body weight, smoking, excessive alcohol use, and certain medications such as long-term glucocorticoids. Secondary osteoporosis can result from endocrine disorders, malabsorption, inflammatory diseases, and other chronic conditions or treatments.

Diagnosis relies on bone mineral density testing, typically with dual-energy X-ray absorptiometry (DEXA). A T-score of -2.5 or lower defines osteoporosis, while scores between -1.0 and -2.5 indicate osteopenia. Clinical assessment of fracture risk may also use tools such as FRAX. Imaging of the spine can detect vertebral fractures that may not cause symptoms.

Prevention and management emphasize adequate calcium and vitamin D, regular weight-bearing and resistance exercise, fall prevention, smoking cessation, and limiting alcohol. Treatments to reduce fracture risk include bisphosphonates (eg, alendronate, risedronate, ibandronate), denosumab, selective estrogen receptor modulators, and anabolic agents such as teriparatide or romosozumab. Revascularization of therapies, vitamin supplementation, and addressing secondary causes are also important.

Osteoporosis affects millions worldwide, with a higher burden among older adults, particularly postmenopausal women. Early detection and ongoing management aim to prevent fractures and preserve quality of life.