The prevalence of low bone mineral density in the elderly is high, with osteopenia found in 37% of postmenopausal women. Primary prevention of osteoporosis begins with identification of risk factors (older age, female gender. White or Asian race, low calcium intake, smoking, excessive alcohol use, and chronic glucocorticoid use). Calcium carbonate (500 mg three times daily) and vitamin D (400-800 lU/d) reduce the risk of osteoporotic fractures in both men and women. Bone mineral density testing using dual-energy x-ray absorptiometry (DEXA) of patients with multiple risk factors may uncover asymptomatic osteoporosis.
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