The Mayo Clinic: Many factors can raise risk of osteoporosis

DEAR MAYO CLINIC: My mother was diagnosed with osteoporosis when she was in her 80s. My sister and I are now in our 60s, and my sister is concerned that we’re at high risk for the disease. I thought osteoporosis was just part of aging, especially for women. Can it run in families? Are there other things that can put a person at risk for it?

ANSWER: Although osteoporosis is more common as people age, it’s not a natural part of aging. A number of factors, including family history, can raise your risk for osteoporosis.

Your body regularly makes new bone and breaks down old bone. When you’re young, your body makes new bone faster than it breaks down old bone, and your bone mass increases. Most people reach their peak bone mass in their mid-20s to mid-30s. The higher your peak bone mass, the more bone your body has to sustain through the rest of your life.

Osteoporosis risk rises with age because as you get older, you lose bone faster than your body can create it. Osteoporosis occurs when the body’s creation of new bone can no longer keep up with the breakdown of old bone. Bones then become weak and brittle and break easily.

Also, if you have a parent or sibling with the disease, you are at greater risk, especially if your mother or father experienced a hip fracture.

Women are at higher risk, particularly those past menopause. That’s because women tend to lose bone density quickly in the years after menopause. That’s not to say men can’t get osteoporosis. About 20% of people diagnosed with the disease are male. Both men and women who have small body frames tend to have a higher risk because they may have less bone mass to draw from as they age.

Diabetes increases the risk. It’s been known for some time that type 1 diabetes contributes to the risk of osteoporosis. That’s because type 1 often starts in childhood and can work against bone strength as people grow. More recently, though, it’s been found that people with type 2 diabetes also have an increased risk.

It’s not clear why. This question currently is the subject of a considerable amount of research.

Diet can make a difference too. A long-term lack of calcium plays a major role in the development of osteoporosis. Low calcium intake contributes to diminished bone density, early bone loss and an increased risk of fractures. Vitamin D deficiency can contribute to lower bone density over time as well.

Another major risk factor for osteoporosis is a broken bone as a child or young adult. Now, many children break bones, but they’re often fingers, toes, arms or collarbones broken during a vehicle accident or sporting event. That’s not the type of broken bone that puts you at risk for osteoporosis.

Instead, if a child’s bone breaks because of a minor trauma — a minor fall, for example — that could be a sign of predisposition to osteoporosis later in life. This is especially true if the broken bone is the wrist, hip, spine or shoulder.

If you’re concerned about your osteoporosis risk, talk with your doctor. For women who’ve never broken a bone and who don’t have other risk factors, it’s recommended that they have a bone density test to screen for osteoporosis at age 60. For men, it’s 70.

If you’re younger than that and have risk factors, the test should be done sooner. For some people, depending on their level of risk, that could be as soon as age 50. — Dr. Bart Clarke, endocrinology, Mayo Clinic, Rochester, Minn.

The MAYO CLINIC Q&A is an educational resource and doesn’t replace regular medical care. Email questions to MayoClinicQ&[email protected]. For more information, visit mayoclinic.org.