Osteopenia: Low Bone Density Precursor to Osteoporosis

Osteopenia is a condition of below-peak bone mineral density (BMD)—T-score between -1.0 and -2.5 SD (WHO criteria). It is less severe than osteoporosis (T-score ≤ -2.5) but indicates increased fracture risk and warrants preventive action.

Risk Factors

• Age >50, female sex, postmenopausal estrogen loss
• Low calcium/vitamin D intake, sedentary lifestyle, smoking, excess alcohol
• Corticosteroid use, rheumatoid arthritis, malabsorption, family history

Management

• Weight-bearing and resistance exercise
• Adequate calcium (1000–1200 mg/day) and vitamin D (800–1000 IU/day)
• Fall prevention (home safety, vision check, balance training)
• FRAX® assessment to guide pharmacologic therapy (bisphosphonates, etc.) if 10-year major osteoporotic fracture risk ≥20% or hip fracture risk ≥3%
• DEXA monitoring every 2–3 years

Early intervention can stabilize or improve BMD and prevent progression to osteoporosis.