<h1 style="text-align: justify;">Osteoporosis&nbsp;</h1>
<img style="display: block; margin-left: auto; margin-right: auto;" src="https://chblob.icloudhospital.com/thumbnails/1-Osteoporosis-8b0b308b-a283-4e82-aeb1-587fc60edaf3.webp" alt="Osteoporosis&nbsp;" width="880" height="423" id="lcp">
Osteoporosis&nbsp;is a condition where bones become weak and brittle, to the point that even minor stressors like leaning over and coughing can result in a fracture. The hip, wrist, and spine are the most prevalent sites for osteoporosis-related fractures.&nbsp;
Bone is a living tissue that can break down and replace itself regularly. When the formation of new bone fails to keep up with the old bone loss, osteoporosis develops. The disease frequently progresses without causing any signs of discomfort and goes undetected until the weakening bones result in severe fractures.&nbsp;
Osteoporosis can strike anyone at any age, but it is more prevalent in older persons, particularly women. More than 52 million individuals have osteoporosis or have an increased risk of getting it in most countries.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Signs and Symptoms of Osteoporosis&nbsp;</h2>
During the early phases of bone loss, there are usually no&nbsp;osteoporosis symptoms. However, if your bones have been compromised by osteoporosis, you may experience the following indications and symptoms:&nbsp;
<ul>
<li style="text-align: justify;">A fractured or compressed vertebra causing back pain.</li>
<li style="text-align: justify;">Height loss over time</li>
<li style="text-align: justify;">A stooping position</li>
<li style="text-align: justify;">A bone that is significantly more easily broken than expected</li>
</ul>
Osteoporosis might worsen if not treated properly. Fractures become more likely when bones become thin and weaker. A fracture due to a fall or an intense sneeze and cough might be signs of severe osteoporosis.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Causes of Osteoporosis&nbsp;</h2>
<img style="display: block; margin-left: auto; margin-right: auto;" src="https://chblob.icloudhospital.com/thumbnails/2-Osteoporosis-e831f21d-292b-4f52-98af-02a594eab2ef.webp" alt="Causes of Osteoporosis" width="667" height="495">
The bones are constantly being renewed, with new bone being formed while the old bone breaks down. Your body generates new bone quicker, unlike how it breaks down the older one while you are young. Hence, an increase in your bone mass.&nbsp;
However, this process starts to slow down as soon as one hits the early twenties. Most individuals get to their climax bone mass at the age of thirty. On the other hand, bone mass loss occurs quicker than it is formed as people age.&nbsp;
The likelihood of developing osteoporosis is largely determined by the amount of bone mass you had during your childhood. Peak bone mass is inherited to some extent and can vary due to ethnic group. Therefore, the more bone you have, the lower your chances of developing osteoporosis when you get older.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Risk Factors of Osteoporosis&nbsp;</h2>
Various factors can increase the chances of getting osteoporosis.&nbsp;
<h4 style="line-height: 150%; text-align: justify;">Unavoidable risk factors:</h4>
Some of the&nbsp;osteoporosis risk factors&nbsp;that are out of control can include the following;
<ul type="disc">
<li style=" line-height: 150%; text-align: justify;" data-list="6" data-level="1">Age:&nbsp;Past the mid-30s, and particularly after menopause, the risk of developing osteoporosis rises.&nbsp;&nbsp;</li>
<li style=" line-height: 150%; text-align: justify;" data-list="6" data-level="1">Genetic aspects:&nbsp;Osteoporosis is more prevalent if a close blood relative has been diagnosed with osteoporosis or a hip fracture.&nbsp;&nbsp;</li>
<li style=" line-height: 150%; text-align: justify;" data-list="6" data-level="1">Ethnicity:&nbsp;According to studies, white and Asian individuals are at a high risk of the disease than persons from other ethnicities.&nbsp;</li>
<li style=" line-height: 150%; text-align: justify;" data-list="6" data-level="1">Height and weight:&nbsp;A person taller than 5 feet and 7 inches or weighing less than 125 pounds are at a higher risk.</li>
<li style=" line-height: 150%; text-align: justify;" data-list="6" data-level="1">Previous fracture history:&nbsp;An individual above the age of 50 who has had a past fracture as a result of a minor injury is at risk of developing osteoporosis.&nbsp;</li>
</ul>
<h4 style="line-height: 150%; text-align: justify;">Dietary and lifestyle risk factors:</h4>
People with the following conditions are most likely to develop osteoporosis:
<ul type="disc">
<li style=" line-height: 150%; text-align: justify;" data-list="3" data-level="1">Feeding disorders:&nbsp;Both males and females tend to lose bone mass when they overly reduce their dietary intake and are underweight.&nbsp;&nbsp;</li>
<li style=" line-height: 150%; text-align: justify;" data-list="3" data-level="1">Calcium deficiency:&nbsp;Osteoporosis is caused by a lack of calcium throughout one's life. Lower calcium consumption leads to low bone density, early bone loss, and a higher risk of fractures.</li>
<li style=" line-height: 150%; text-align: justify;" data-list="3" data-level="1">Gastrointestinal surgery:&nbsp;The quantity of surface area accessible to take up nutrients, like calcium, decreases when your stomach reduces in size or a portion of your intestine is removed. Surgical procedures to help you cut off weight and treat other gastrointestinal problems are among these procedures.&nbsp;</li>
</ul>
<h4 style="line-height: 150%; text-align: justify;">Hormonal levels:</h4>
People with too much or little specific hormones in the body are more likely to develop osteoporosis. Some of the examples are:
<ul type="disc">
<li style=" line-height: 150%; text-align: justify;" data-list="1" data-level="1">Thyroid issues:&nbsp;Thyroid hormone overproduction can lead to bone loss. It can happen when the thyroid is too active, or you use a lot of thyroid hormone drugs to regulate an underactive thyroid.&nbsp;</li>
<li style=" line-height: 150%; text-align: justify;" data-list="1" data-level="1">Low sex hormones:&nbsp;Reduced levels of estrogen seem to make bone regeneration more difficult.</li>
<li style=" line-height: 150%; text-align: justify;" data-list="1" data-level="1">Other glands:&nbsp;Overactive adrenal glands and parathyroid glands are linked to osteoporosis.</li>
</ul>
<h4 style="line-height: 150%; text-align: justify;">Drugs and medical conditions:</h4>
The bone-rebuilding course can be hampered by prolonged usage of corticosteroid medicines like prednisone and cortisone, either orally or intravenously. Osteoporosis is also linked to the use of drugs to treat or prevent gastric reflux, seizures, cancer, and rejection of a transplant.
On the other hand, osteoporosis is more likely in people with specific medical conditions. Examples of these conditions are celiac disease, lupus, inflammatory bowel disease, multiple myeloma, and rheumatoid arthritis.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Osteoporosis Diagnosis&nbsp;</h2>
<img style="display: block; margin-left: auto; margin-right: auto;" src="https://chblob.icloudhospital.com/thumbnails/3-Osteoporosis-e40766b3-2e3e-4075-9091-3e6e5f506db2.webp" alt="Osteoporosis Diagnosis&nbsp;" width="742" height="495">
Before severe problems arise, your orthopedics doctor might conduct a test to obtain your overall bone health information. In most cases, they will recommend a bone mineral density (BMD) scanning. It uses dual-energy x-ray absorptiometry (DEXA), a form of specialized x-ray.&nbsp;
These x-rays employ very small doses of radiation to assess the strength of the bones in the hip, spine, and wrist. Routine x-rays will only reveal osteoporosis after the disease has progressed significantly.&nbsp;
A bone density test is recommended for all women above 65 years of age. For women with an increased risk of osteoporosis, a DEXA scan may be performed earlier. Men who are over the age of 70, as well as younger men who have risk factors, need to obtain a bone density scan.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Osteoporosis Treatment&nbsp;</h2>
If the diagnostic tests reveal that you have osteoporosis, the healthcare provider will work with you to develop a suitable treatment plan. Although osteoporosis has no cure, appropriate treatment could help in maintaining and strengthening your bones. They can also help delay the bone breakdown in your body, while some can even stimulate new bone growth.
The following are the common&nbsp;osteoporosis treatment&nbsp;options;&nbsp;
<h4 style="line-height: 150%; text-align: justify;">Osteoporosis medications and therapy:&nbsp;</h4>
Medical providers can recommend the following&nbsp;osteoporosis medications&nbsp;to help address the problem;&nbsp;
<ul>
<li style="text-align: justify;">Bisphosphonates&nbsp;</li>
</ul>
These are the most commonly recommended osteoporosis drugs for both men and women who are at risk of fracture. Some of the examples are Alendronate (Binosto and Fosamax), Ibandronate (Boniva), Risedronate (Actonel and Atelvia), and Zoledronic (Reclast and Zometa).&nbsp;&nbsp;
<ul type="disc">
<li style=" line-height: 150%; text-align: justify;" data-list="0" data-level="1">Monoclonal antibody drugs&nbsp;</li>
</ul>
Denosumab (Prolia and Xgeva) provides equal or improved bone density outcomes than bisphosphonates. It also lowers the risk of all sorts of fractures. Every 6 months, denosumab is given as an injection beneath the skin.&nbsp;
<ul type="disc">
<li style=" line-height: 150%; text-align: justify;" data-list="5" data-level="1">Hormone-related therapy</li>
</ul>
Testosterone, estrogen, and the selective estrogen receptor modulator raloxifene are examples of hormone therapy options. Estrogen therapy is mostly recommended for women with menopause-related symptoms or young women due to the risk of blood clots, some malignancies, and heart problems. For men with low levels of testosterone, the doctor may prescribe testosterone to boost their bone density.
Raloxifene has an estrogen-like effect on the bones. The medication comes in the form of a tablet and must be taken daily. The doctor can also suggest Raloxifene to minimize breast cancer risks for some women in addition to addressing osteoporosis. It is usually taken for five years to treat osteoporosis.&nbsp;&nbsp;
<h4 style="line-height: 150%; text-align: justify;">Osteoporosis diet:&nbsp;</h4>
An appropriate diet, in addition to the treatment plan, can assist in strengthening your bones. Some nutrients must be included in your regular diet to maintain your bones strong. Vitamin D and calcium are the most crucial. Calcium is required for strong bones, while vitamin D is necessary for calcium absorption. Magnesium, protein, zinc, and vitamin K are some of the additional nutrients that enhance bone health.&nbsp;
&nbsp;
<h3 style="line-height: 150%; text-align: justify;">Prevention of Osteoporosis&nbsp;</h3>
Most risk factors associated with osteoporosis are beyond your control. Being a woman, growing older, or having a family history of the disease are some of these risk factors. Nevertheless, there are several elements over which you have control.&nbsp;
The following are some of the most effective ways of&nbsp;osteoporosis prevention;&nbsp;
<ul>
<li style="text-align: justify;">Consuming the required quantity of calcium and vitamin D on a daily basis</li>
<li style="text-align: justify;">Doing workouts that require you to carry weight</li>
<li style="text-align: justify;">Smoking cessation</li>
<li style="text-align: justify;">Analyzing the benefits and drawbacks of hormone therapy for women</li>
</ul>
&nbsp;
<h3 style="line-height: 150%; text-align: justify;">Complications of Osteoporosis&nbsp;</h3>
The most significant side effect of osteoporosis is bone fractures, mainly in the spine or hip. A fall is the most common cause of hip fractures. This could lead to disability and sometimes a higher risk of death in the first year following the injury or damage.&nbsp;
Even when you have never fallen, you may still have a spinal fracture. Back pain, height loss, and a leaned forward posture can all occur from the bones making up the spine (or vertebrae). Hence, they tend to weaken to the extent of crumpling.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Conclusion&nbsp;</h2>
Osteoporosis is a disease with devastating consequences. Fractures can result, which are extremely painful and take a longer period to heal. They can also lead to other associated issues.&nbsp;
Consult your doctor if you believe you are at high risk for osteoporosis or have been diagnosed with it. He or she can work with you to develop a preventative or treatment strategy that will help you boost your bone health and lower your risk of certain complications.&nbsp;

<h1 style="text-align: justify;">Osteoporosis&nbsp;</h1>
<img style="display: block; margin-left: auto; margin-right: auto;" src="https://chblob.icloudhospital.com/thumbnails/1-Osteoporosis-8b0b308b-a283-4e82-aeb1-587fc60edaf3.webp" alt="Osteoporosis&nbsp;" width="880" height="423">
Osteoporosis&nbsp;is a condition where bones become weak and brittle, to the point that even minor stressors like leaning over and coughing can result in a fracture. The hip, wrist, and spine are the most prevalent sites for osteoporosis-related fractures.&nbsp;
Bone is a living tissue that can break down and replace itself regularly. When the formation of new bone fails to keep up with the old bone loss, osteoporosis develops. The disease frequently progresses without causing any signs of discomfort and goes undetected until the weakening bones result in severe fractures.&nbsp;
Osteoporosis can strike anyone at any age, but it is more prevalent in older persons, particularly women. More than 52 million individuals have osteoporosis or have an increased risk of getting it in most countries.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Signs and Symptoms of Osteoporosis&nbsp;</h2>
During the early phases of bone loss, there are usually no&nbsp;osteoporosis symptoms. However, if your bones have been compromised by osteoporosis, you may experience the following indications and symptoms:&nbsp;
<ul>
<li style="text-align: justify;">A fractured or compressed vertebra causing back pain.</li>
<li style="text-align: justify;">Height loss over time</li>
<li style="text-align: justify;">A stooping position</li>
<li style="text-align: justify;">A bone that is significantly more easily broken than expected</li>
</ul>
Osteoporosis might worsen if not treated properly. Fractures become more likely when bones become thin and weaker. A fracture due to a fall or an intense sneeze and cough might be signs of severe osteoporosis.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Causes of Osteoporosis&nbsp;</h2>
<img style="display: block; margin-left: auto; margin-right: auto;" src="https://chblob.icloudhospital.com/thumbnails/2-Osteoporosis-e831f21d-292b-4f52-98af-02a594eab2ef.webp" alt="Causes of Osteoporosis" width="667" height="495">
The bones are constantly being renewed, with new bone being formed while the old bone breaks down. Your body generates new bone quicker, unlike how it breaks down the older one while you are young. Hence, an increase in your bone mass.&nbsp;
However, this process starts to slow down as soon as one hits the early twenties. Most individuals get to their climax bone mass at the age of thirty. On the other hand, bone mass loss occurs quicker than it is formed as people age.&nbsp;
The likelihood of developing osteoporosis is largely determined by the amount of bone mass you had during your childhood. Peak bone mass is inherited to some extent and can vary due to ethnic group. Therefore, the more bone you have, the lower your chances of developing osteoporosis when you get older.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Risk Factors of Osteoporosis&nbsp;</h2>
Various factors can increase the chances of getting osteoporosis.&nbsp;
<h4 style="line-height: 150%; text-align: justify;">Unavoidable risk factors:</h4>
Some of the&nbsp;osteoporosis risk factors&nbsp;that are out of control can include the following;
<ul type="disc">
<li style=" line-height: 150%; text-align: justify;" data-list="6" data-level="1">Age:&nbsp;Past the mid-30s, and particularly after menopause, the risk of developing osteoporosis rises.&nbsp;&nbsp;</li>
<li style=" line-height: 150%; text-align: justify;" data-list="6" data-level="1">Genetic aspects:&nbsp;Osteoporosis is more prevalent if a close blood relative has been diagnosed with osteoporosis or a hip fracture.&nbsp;&nbsp;</li>
<li style=" line-height: 150%; text-align: justify;" data-list="6" data-level="1">Ethnicity:&nbsp;According to studies, white and Asian individuals are at a high risk of the disease than persons from other ethnicities.&nbsp;</li>
<li style=" line-height: 150%; text-align: justify;" data-list="6" data-level="1">Height and weight:&nbsp;A person taller than 5 feet and 7 inches or weighing less than 125 pounds are at a higher risk.</li>
<li style=" line-height: 150%; text-align: justify;" data-list="6" data-level="1">Previous fracture history:&nbsp;An individual above the age of 50 who has had a past fracture as a result of a minor injury is at risk of developing osteoporosis.&nbsp;</li>
</ul>
<h4 style="line-height: 150%; text-align: justify;">Dietary and lifestyle risk factors:</h4>
People with the following conditions are most likely to develop osteoporosis:
<ul type="disc">
<li style=" line-height: 150%; text-align: justify;" data-list="3" data-level="1">Feeding disorders:&nbsp;Both males and females tend to lose bone mass when they overly reduce their dietary intake and are underweight.&nbsp;&nbsp;</li>
<li style=" line-height: 150%; text-align: justify;" data-list="3" data-level="1">Calcium deficiency:&nbsp;Osteoporosis is caused by a lack of calcium throughout one's life. Lower calcium consumption leads to low bone density, early bone loss, and a higher risk of fractures.</li>
<li style=" line-height: 150%; text-align: justify;" data-list="3" data-level="1">Gastrointestinal surgery:&nbsp;The quantity of surface area accessible to take up nutrients, like calcium, decreases when your stomach reduces in size or a portion of your intestine is removed. Surgical procedures to help you cut off weight and treat other gastrointestinal problems are among these procedures.&nbsp;</li>
</ul>
<h4 style="line-height: 150%; text-align: justify;">Hormonal levels:</h4>
People with too much or little specific hormones in the body are more likely to develop osteoporosis. Some of the examples are:
<ul type="disc">
<li style=" line-height: 150%; text-align: justify;" data-list="1" data-level="1">Thyroid issues:&nbsp;Thyroid hormone overproduction can lead to bone loss. It can happen when the thyroid is too active, or you use a lot of thyroid hormone drugs to regulate an underactive thyroid.&nbsp;</li>
<li style=" line-height: 150%; text-align: justify;" data-list="1" data-level="1">Low sex hormones:&nbsp;Reduced levels of estrogen seem to make bone regeneration more difficult.</li>
<li style=" line-height: 150%; text-align: justify;" data-list="1" data-level="1">Other glands:&nbsp;Overactive adrenal glands and parathyroid glands are linked to osteoporosis.</li>
</ul>
<h4 style="line-height: 150%; text-align: justify;">Drugs and medical conditions:</h4>
The bone-rebuilding course can be hampered by prolonged usage of corticosteroid medicines like prednisone and cortisone, either orally or intravenously. Osteoporosis is also linked to the use of drugs to treat or prevent gastric reflux, seizures, cancer, and rejection of a transplant.
On the other hand, osteoporosis is more likely in people with specific medical conditions. Examples of these conditions are celiac disease, lupus, inflammatory bowel disease, multiple myeloma, and rheumatoid arthritis.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Osteoporosis Diagnosis&nbsp;</h2>
<img style="display: block; margin-left: auto; margin-right: auto;" src="https://chblob.icloudhospital.com/thumbnails/3-Osteoporosis-e40766b3-2e3e-4075-9091-3e6e5f506db2.webp" alt="Osteoporosis Diagnosis&nbsp;" width="742" height="495">
Before severe problems arise, your orthopedics doctor might conduct a test to obtain your overall bone health information. In most cases, they will recommend a bone mineral density (BMD) scanning. It uses dual-energy x-ray absorptiometry (DEXA), a form of specialized x-ray.&nbsp;
These x-rays employ very small doses of radiation to assess the strength of the bones in the hip, spine, and wrist. Routine x-rays will only reveal osteoporosis after the disease has progressed significantly.&nbsp;
A bone density test is recommended for all women above 65 years of age. For women with an increased risk of osteoporosis, a DEXA scan may be performed earlier. Men who are over the age of 70, as well as younger men who have risk factors, need to obtain a bone density scan.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Osteoporosis Treatment&nbsp;</h2>
If the diagnostic tests reveal that you have osteoporosis, the healthcare provider will work with you to develop a suitable treatment plan. Although osteoporosis has no cure, appropriate treatment could help in maintaining and strengthening your bones. They can also help delay the bone breakdown in your body, while some can even stimulate new bone growth.
The following are the common&nbsp;osteoporosis treatment&nbsp;options;&nbsp;
<h4 style="line-height: 150%; text-align: justify;">Osteoporosis medications and therapy:&nbsp;</h4>
Medical providers can recommend the following&nbsp;osteoporosis medications&nbsp;to help address the problem;&nbsp;
<ul>
<li style="text-align: justify;">Bisphosphonates&nbsp;</li>
</ul>
These are the most commonly recommended osteoporosis drugs for both men and women who are at risk of fracture. Some of the examples are Alendronate (Binosto and Fosamax), Ibandronate (Boniva), Risedronate (Actonel and Atelvia), and Zoledronic (Reclast and Zometa).&nbsp;&nbsp;
<ul type="disc">
<li style=" line-height: 150%; text-align: justify;" data-list="0" data-level="1">Monoclonal antibody drugs&nbsp;</li>
</ul>
Denosumab (Prolia and Xgeva) provides equal or improved bone density outcomes than bisphosphonates. It also lowers the risk of all sorts of fractures. Every 6 months, denosumab is given as an injection beneath the skin.&nbsp;
<ul type="disc">
<li style=" line-height: 150%; text-align: justify;" data-list="5" data-level="1">Hormone-related therapy</li>
</ul>
Testosterone, estrogen, and the selective estrogen receptor modulator raloxifene are examples of hormone therapy options. Estrogen therapy is mostly recommended for women with menopause-related symptoms or young women due to the risk of blood clots, some malignancies, and heart problems. For men with low levels of testosterone, the doctor may prescribe testosterone to boost their bone density.
Raloxifene has an estrogen-like effect on the bones. The medication comes in the form of a tablet and must be taken daily. The doctor can also suggest Raloxifene to minimize breast cancer risks for some women in addition to addressing osteoporosis. It is usually taken for five years to treat osteoporosis.&nbsp;&nbsp;
<h4 style="line-height: 150%; text-align: justify;">Osteoporosis diet:&nbsp;</h4>
An appropriate diet, in addition to the treatment plan, can assist in strengthening your bones. Some nutrients must be included in your regular diet to maintain your bones strong. Vitamin D and calcium are the most crucial. Calcium is required for strong bones, while vitamin D is necessary for calcium absorption. Magnesium, protein, zinc, and vitamin K are some of the additional nutrients that enhance bone health.&nbsp;
&nbsp;
<h3 style="line-height: 150%; text-align: justify;">Prevention of Osteoporosis&nbsp;</h3>
Most risk factors associated with osteoporosis are beyond your control. Being a woman, growing older, or having a family history of the disease are some of these risk factors. Nevertheless, there are several elements over which you have control.&nbsp;
The following are some of the most effective ways of&nbsp;osteoporosis prevention;&nbsp;
<ul>
<li style="text-align: justify;">Consuming the required quantity of calcium and vitamin D on a daily basis</li>
<li style="text-align: justify;">Doing workouts that require you to carry weight</li>
<li style="text-align: justify;">Smoking cessation</li>
<li style="text-align: justify;">Analyzing the benefits and drawbacks of hormone therapy for women</li>
</ul>
&nbsp;
<h3 style="line-height: 150%; text-align: justify;">Complications of Osteoporosis&nbsp;</h3>
The most significant side effect of osteoporosis is bone fractures, mainly in the spine or hip. A fall is the most common cause of hip fractures. This could lead to disability and sometimes a higher risk of death in the first year following the injury or damage.&nbsp;
Even when you have never fallen, you may still have a spinal fracture. Back pain, height loss, and a leaned forward posture can all occur from the bones making up the spine (or vertebrae). Hence, they tend to weaken to the extent of crumpling.&nbsp;
&nbsp;
<h2 style="line-height: 150%; text-align: justify;">Conclusion&nbsp;</h2>
Osteoporosis is a disease with devastating consequences. Fractures can result, which are extremely painful and take a longer period to heal. They can also lead to other associated issues.&nbsp;
Consult your doctor if you believe you are at high risk for osteoporosis or have been diagnosed with it. He or she can work with you to develop a preventative or treatment strategy that will help you boost your bone health and lower your risk of certain complications.&nbsp;

Osteoporosis or “porous bone” is a disease characterized by low bone mass and structural deterioration of bone tissue which adds to a higher risk of fractures of the hip, spine, and wrist.