Prevalence of Osteopenia in Women Over 60
More than 60% of White women older than 64 years have osteopenia 1, making this condition extremely common in the post-menopausal population.
Key Epidemiological Data
The prevalence of low bone density in women over 60 varies by diagnostic category:
- Approximately 48% of postmenopausal women aged 60-94 years have osteopenia (T-score between -1.0 and -2.5) 2
- 37.6% have normal bone mineral density 2
- 14.5% have osteoporosis (T-score ≤ -2.5) 2
These figures indicate that the majority of older women (approximately 62.5%) have either osteopenia or osteoporosis, with osteopenia being substantially more prevalent than frank osteoporosis 2.
Clinical Significance
The high prevalence of osteopenia is clinically critical because over half (56.5%) of all fragility fractures occur in women with osteopenia, not osteoporosis 2. This occurs despite the fact that individual fracture risk is lower in osteopenic women compared to those with osteoporosis—the sheer number of women with osteopenia means they account for the majority of the population fracture burden 1, 2.
Important Risk Stratification
- Approximately 40% of women will experience one or more fractures after age 50 3
- More than 40% of women will suffer fractures by age 70 4
- Women with osteopenia plus a prevalent fracture have the same fracture risk as women with osteoporosis alone 2
Screening Implications
Given this high prevalence, the U.S. Preventive Services Task Force strongly recommends screening all women aged 65 years or older for osteoporosis using DXA of the hip and lumbar spine 5. The American College of Radiology similarly recommends DXA as the primary imaging modality for screening in women >65 years 6.
Common Pitfall
Do not assume that osteopenia diagnosis means low risk—fracture risk varies widely within the osteopenic range depending on age, BMD level, fracture history, and other clinical factors 1. The diagnosis of osteopenia should trigger quantitative fracture risk calculation (such as FRAX), not simply reassurance 1.