What is the role of aging in age the pathogenesis of osteoporosis?

Updated: Jan 20, 2021
  • Author: Rachel Elizabeth Whitaker Elam, MD, MSc; Chief Editor: Herbert S Diamond, MD  more...
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Postmenopausal bone loss is associated with excessive osteoclast activity. Senile osteoporosis may also be associated with excessive osteoclast activity but there may also be a progressive decline in the supply of osteoblasts in proportion to the demand. This demand is ultimately determined by the frequency with which new multicellular units are created and new cycles of remodeling are initiated.

After the third decade of life, bone resorption exceeds bone formation and leads to osteopenia and, in severe situations, osteoporosis. Women lose 30-40% of their cortical bone and 50% of their trabecular bone over their lifetime, as opposed to men, who lose 15-20% of their cortical bone and 25-30% of trabecular bone. Aging deteriorates bone structure, composition, and function leading to  bone loss being evident before sex steroid deficiency. Aging results in a combination of cortical thinning, increased cortical porosity, thinning of the trabeculae, and loss of trabecular connectivity.  [29]

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