The changing rule of human bone density with aging based on a novel definition and mensuration of bone density with computed tomography

Abstract: Osteoporosis and fragility fractures have emerged as major public health concerns in an aging population. However, measuring age-related changes in bone density using dual-energy X-ray absorptiometry has limited personalized risk assessment due to susceptibility to interference from various factors. In this study, we propose an innovative statistical model of bone pixel distribution in fine-segmented computed tomography (CT) images, along with a novel approach to measuring bone density based on CT values of bone pixels. Our findings indicate that bone density exhibits a linear decline with age during adulthood between the ages of 39 and 80, with the rate of decline being approximately 1.6 times faster in women than in men. This contradicts the widely accepted notion that bone density starts declining in women at menopause and in men at around 50 years of age. The linearity of age-related changes provides further insights into the dynamics of the aging human body. Consequently, our findings suggest that the definition of osteoporosis by the World Health Organization should be revised to the standard deviation of age-based bone density. Furthermore, these results open up new avenues for research in bone health care and clinical investigation of osteoporosis.