Why is it that one elderly person will have a mild fall resulting in a fracture of the wrist or even hip while another gets up and walks away? Such an unexpected broken bone often is a warning sign of the condition called osteoporosis, which can have severe health consequences down the road if not taken seriously or detected. It is estimated that one out of 5 American women over age 50 has osteoporosis and half of them will have a fracture of the hip, wrist, spine or pelvis. This condition actually starts after age 30 and slowly reduces the strength of the skeleton; in women within 5 years after menopause, there can be a very rapid and severe loss of calcium and weakened bone density. Men are also affected but later in life. Besides the normal aging process other factors that cause osteoporosis are lack of vitamin D, family history of brittle bones, smoking, insufficient weight-bearing exercise, low body weight, diabetes or more than 2 alcohol drinks per day. These fractures can be prevented by risk factor modification and/or medication, thereby avoiding possible future chronic pain and loss of independence. When I was medical director of our local nursing homes, one of the more common conditions I had to deal with was hip fracture, which can in an instant change the status of an elderly individual from independently living at home to requiring facility care, often for the rest of one's life.