What Is Osteopenia?

You've heard of osteoarthritis and osteoporosis, but what about osteopenia?  Often a precursor to osteoporosis, osteopenia is simply low bone mass.  The World Health Organization defines osteopenia based on bone mineral density values between 1.0 and 2.5 standard deviations below the average of bone mass for the young adult normal population; osteoporosis would begin at 2.5 standard deviations or more from this normal level.  According to this definition, osteopenia may affect nearly 16% of the young adult female population and up to 40% of women over age 50.  This represents a very large segment of the population who would be at increased risk for osteoporosis. 

While osteopenia has not traditionally been associated with an increased bone fracture risk, the National Osteoporosis Risk Assessment (NORA) has shown that women with osteopenia have a 1.8 times greater risk of fracturing their forearm, heel or finger than women with a normal bone density.  While this is a significantly lower risk of fracture than women with osteoporosis (who are 4 times a likely as women with a normal bone mass to have a fracture), it is still a significant risk about which most women with osteopenia are simply not aware.

How would you know if you have osteopenia?  The only way to find out is to have a bone mineral density (BMD) test, the same non-invasive diagnostic test used for osteoporosis.  While pharmacologic treatment is rarely recommended for a woman with osteopenia, there are steps that women with this diagnosis can take to reduce their risk of bone fractures and progression to osteoporosis.  Modifying behavioral risk factors is key:  stop smoking, increase weight-bearing exercise, increase dietary calcium and vitamin D.  Most importantly, ask your doctor what kind of follow-up you should have, particularly when you should have a follow-up BMD test. 

Created: 10/28/2003  -  Donnica Moore, M.D.