About half of postmenopausal women have a bone density T score at the femoral neck between −1.0 and −2.5. Bone density in this range was termed “osteopenia” by a World Health Organization working group. Osteopenia is not a disease and the label can cause unnecessary anxiety. Osteopenia encompasses a wide range of fracture risks; an individual patient's risk can be estimated from her age, bone mineral density, and clinical risk factors. Regardless of bone mineral density, regular exercise and adherence with vitamin D and calcium intake may reduce the risk of hip fracture. Osteopenia by itself is not an indication for treatment. Decisions about pharmacological treatment to prevent fractures should be based on the patient's risk of fractures, evidence about the efficacy and nonskeletal effects of the specific treatment, and the patient's preferences.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Previously unpublished data from 5 years of more than 98% follow-up of 8134 women aged 67 years or older after measurement of hip BMD by dual x-ray absorptiometry. Dashed lines indicate 95% confidence intervals. Methods described in Cummings et al.1
A, Risk of low trauma nonspine (nonvertebral) fracture. B, Risk of a radiograph-defined vertebral fracture. C, Risk of hip fracture.2
Low femoral neck bone mineral density (BMD) is defined as T score <−1.5. Based on data from the placebo group for the Fracture Intervention Trial (FIT).65,68,70,80 No vertebral fractures at baseline data are derived from the participants who had low BMD of the femoral neck (T score <1.5 but no vertebral fracture65). Vertebral fractures at baseline data are derived from participants who had a vertebral fracture.70 The percentage is a function of the mean number of self-reported days of limited activity following each type of fracture81 and the incidence of that type of fracture. Methods for assessing days of disability for each type of fracture are described by Fink and colleagues,81 and the incidence of various types of fractures in FIT have also been published.65,68
The subgroup analysis was prespecified and the interaction between baseline BMD and the effect of alendronate was P = .02.65
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Thank you for submitting a comment on this article. It will be reviewed by JAMA editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 14
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Register Now
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Need assistance?
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.