This first-ever Surgeon General's Report on bone health and osteoporosis illustrates the large burden that bone disease places on our Nation and its citizens. Like other chronic diseases that disproportionately affect the elderly, the prevalence of bone disease and fractures is projected to increase markedly as the population ages. If these predictions come true, bone disease and fractures will have a tremendous negative impact on the future well-being of Americans. But as this report makes clear, they need not come true: by working together we can change the picture of aging in America. Osteoporosis, fractures, and other chronic diseases no longer should be thought of as an inevitable part of growing old. By focusing on prevention and lifestyle changes, including physical activity and nutrition, as well as early diagnosis and appropriate treatment, Americans can avoid much of the damaging impact of bone disease and other chronic diseases. This Surgeon General's Report brings together for the first time the scientific evidence related to the prevention, assessment, diagnosis, and treatment of bone disease. More importantly, it provides a framework for moving forward. The report will be another effective tool in educating Americans about how they can promote bone health throughout their lives. This first-ever Surgeon General's Report on bone health and osteoporosis provides much needed information on bone health, an often overlooked aspect of physical health. This report follows in the tradition of previous Surgeon Generals' reports by identifying the relevant scientific data, rigorously evaluating and summarizing the evidence, and determining conclusions.

There are a number of therapies and treatments available for the prevention of fragility fractures in people thought to be at risk, or to prevent further fractures in those who have already had one or more fragility fractures. However, identifying who will benefit from preventative treatment is imprecise. A number of risk assessment tools are available to predict fracture incidence over a period of time, and these may be used to aid decision making. These tools are limited in that they may not include all risk factors, or may lack details of some risk factors. Tools are dependent on the accuracy of the epidemiological data used to derive them and tools validated in other populations may not apply to the UK. Two tools, FRAX and QFracture, are available for use in the UK. It is not clear whether these tools are equally accurate and whether choice of tool should depend on circumstances. This short clinical guideline aims to provide guidance on the selection and use of risk assessment tools in the care of people who may be at risk of fragility fractures in all settings in which NHS care is received.

Falls, fractures, frailty, osteoporosis and sarcopenia are highly prevalent in older persons. While the concept of osteosarcopenia is new, it is a rapidly evolving and cross-disciplinary problem. Prevention and treatment are challenging and a combined therapeutic approach is needed. Osteosarcopenia provides evidence-based information on how to prevent and treat these conditions at multiple settings, including multiple illustrations, care pathways and tips to easily understand the pathophysiology, diagnostic methods and therapeutic approach to these conditions. This work evaluates the potential for a link between osteoporosis, sarcopenia and obesity. - Presents diagnostic and therapeutic tips that facilitate the design and implementation of new care pathways, impacting the wellbeing of our older population - Provides cross-disciplinary understanding by experts from the bone/osteoporosis field and the muscle/sarcopenia field - Covers muscle and bone biology, mesenchymal stem cells, age-related changes and cross-talk between muscle, fat and bone, falls and fracture risk, glucose metabolism, diagnosis, imaging, and genetics of osteosarcopenia

With an emphasis on exercise and its effect on bone, this text includes sections on basic anatomy and the physiology of the structure and function of bone as well as exercises to maintain a healthy skeleton through to old age.