Osteoporosis: the emperor has no clothes.
Bottom Line: However, all these three notions can be disputed.A high likelihood of falling, in turn, is attributable to an ageing-related decline in physical functioning and general frailty.There are also considerable uncertainties related to the efficacy of drug therapy in preventing clinical vertebral fractures, whereas the efficacy for preventing other fractures (relative risk reductions of 20-25%) remains moderate, particularly in terms of the low absolute risk reduction in fractures with this treatment.
Affiliation: Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.Show MeSH
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Mentions: It is also well established that bone deteriorates with age, but even a weak bone can survive normal life without exceptional loading caused by a fall-induced impact (Fig.1). Fractures are primarily caused by falls , including the case of vertebral fractures . Thus, even asking the simple question ‘Do you have impaired balance?’ can predict about 40% of all hip fractures , whereas osteoporosis predicts <30% . With regard to the distinct fracture incidence between women and men, the higher incidence in women is attributable to a higher incidence of falling, not to lower BMD  (Fig.2).
Affiliation: Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.