Prevalence of osteoporosis in India: an observation of 31238 adults

Sushrut Babhulkar, Shobhit Seth


Background: Aim of the study was to determine the prevalence of bone loss (both osteopenia and osteoporosis) at national and regional levels in India.

Methods: In this retrospective study, data obtained from in-clinic screening camps conducted for bone loss was analysed. Participants were apparently healthy adults (aged 18 years and above) evaluated for bone mineral density (BMD) using calcaneal quantitative ultrasound (QUS) of left foot. Based on t score of BMD obtained, participants were labelled as normal (T-score <-1 SD), osteopenia (t score-1 to -2.5 SD) and osteoporosis (t score <-2.5 SD).

Results: In total, data of 31238 participants was analysed retrospectively. Mean age was 47.8±14.2 years and 47.6% were females. Among females, 38.8% were postmenopausal women (age >50 years). Overall prevalence of osteopenia and osteoporosis was 49.9 and 18.3% respectively. Across East, West, North and South India, the prevalence of osteopenia was 51.3, 47.9, 55.6 and 47.4% respectively whereas prevalence of osteoporosis was 18.4, 16.3, 16.4 and 20.7% respectively. Prevalence of osteoporosis was slightly higher in females than males (19.4 vs 17.3%). Among postmenopausal women, overall osteoporosis prevalence was 33.1% and ranged from 16.9% in North region to 21.8% South region. Prevalence of osteoporosis (37.0 vs 12.5%) was higher in elderly (≥60 years) than adults (<60 years).

Conclusions: Among adults, nearly one out of two have osteopenia and one out of five have osteoporosis. Osteoporosis prevalence was higher in the women and in the elderly. Nearly one out of three women in postmenopausal age group have osteoporosis. There is no substantial difference across the four regions of the country. Considering the significant prevalence of low BMD, there is need to increase the awareness about bone health in general population.




Osteoporosis, Osteopenia, Bone mineral density, Postmenopausal women, Elderly, India

Full Text:



National Institute for Health and Care Excellence (NICE). Bone Health Programme: A Proactive Population Approach to Bone Health. October 2017. Available from: Accessed on 12-June-2020.

WHO scientific group on the assessment of osteoporosis at primary health care level. World Health Organization 2007. Available from: Accessed on 12-June-2020.

International Orthopedics Foundation. Facts and Statistics. Available from: Accessed on 12-June-2020.

World Health Organization. Nutrition. Recommendations for preventing osteoporosis. Available from: Accessed on 12-June-2020.

Khadilkar AV, Mandlik RM. Epidemiology and treatment of osteoporosis in women: an Indian perspective. Int J Womens Health. 2015;7:841-50.

Kaushal N, Vohora D, Jalali RK, Jha S. Prevalence of osteoporosis and osteopenia in an apparently healthy Indian population-a cross-sectional retrospective study. Osteoporos Sarcopenia. 2018;4(2):53-60.

Alonge TO, Adebusoye LA, Ogunbode AM. Factors associated with osteoporosis among older patients at the Geriatric Centre in Nigeria: a cross-sectional study. S Afr Fam Pract. 2017;59:87-93.

Thomas-John M, Codd MB, Manne S, Watts NB, Mongey AB. Risk factors for the development of osteoporosis and osteoporotic fractures among older men. J Rheumatol. 2009;36:1947-52.

Sahni S, Mangano KM, McLean RR, Hannan MT, Kiel DP. Dietary Approaches for Bone Health: Lessons from the Framingham Osteoporosis Study. Curr Osteoporos Rep. 2015;13:245-55.

Elderly in India. Profile and Programmes 2016. Available from Accessed on 12-June-2020.

Hashmi FR, Elfandi KO. Heel Ultrasound Scan in Detecting Osteoporosis in Low Trauma Fracture Patients. Orthop Rev (Pavia). 2016;8:6357.

Gnudi S, Ripamonti C, Malavolta N. Quantitative ultrasound and bone densitometry to evaluate the risk of nonspine fractures: a prospective study. Osteoporos Int. 2000;11:518-23.

Roux C, Laugier P. Quantitative ultrasound evaluation of post-menopausal osteoporosis. J Radiolo. 1999;80:279.

Sung KH, Choi Y, Cho GH. Peripheral DXA measurement around ankle joint to diagnose osteoporosis as assessed by central DXA measurement. Skeletal Radiol. 2018;47:1111-7.

Huopio J, Kröger H, Honkanen R, Jurvelin J, Saarikoski S, Alhava E. Calcaneal ultrasound predicts early postmenopausal fractures as well as axial BMD. A prospective study of 422 women. Osteoporos Int. 2004;15:190-5. Accessed on 15-June-2020.

Marwaha RK, Tandon N, Garg MK, R. Kanwar. Bone health in healthy Indian population aged 50 years and above. Osteoporos Int. 2011;22:2829-36.

Meeta, Digumarti L, Agarwal N, Vaze N, Vaze N, Shah R, Malik S. Clinical practice guidelines on menopause: An executive summary and recommendations. J Mid-life Health. 2013;4:77-106.

Chitten JJ, James B. Prevalence of Osteopenia and Osteoporosis in Orthopaedic Outpatients in Southern India. J Clin Diagn Res. 2018;12: RC14-7.

Singh K, Kumar R, Shukla A. Status of 25-hydroxyvitamin D deficiency and effect of vitamin D receptor gene polymorphisms on bone mineral density in thalassemia patients of North India. Hematol. 2012;17:291-6.

Paul T, Thomas N, Seshadri M, Oommen R, Jose A, Mahendri NV. Prevalence of osteoporosis in ambulatory postmenopausal women from a semiurban region in Southern India: relationship to calcium nutrition and vitamin D status. Endocr Pract. 2008;14:665-71.

Shetty S, Kapoor N, Naik D, Asha HS, Prabu S, Thomas N et al. Osteoporosis in healthy South Indian males and the influence of life style factors and vitamin d status on bone mineral density. J Osteoporos. 2014:723238.

Agrawal NK, Sharma B. Prevalence of osteoporosis in otherwise healthy Indian males aged 50 years and above. Arch Osteoporos. 2013;8:116.

Acharya S, Srivastava A, Sen IB. Osteoporosis in Indian women aged 40-60 years. Arch Osteoporos. 2010;5:83-89.

Silvanus V, Ghosal K, Behera A, Subramanian P. Screening for osteopenia and osteoporosis in an urban community in India. Nepal Med Coll J. 2012;14:247-50.

Kadam NS, Chiplonkar SA, Khadilkar AV, Khadilkar VV. Prevalence of osteoporosis in apparently healthy adults above 40 years of age in Pune City, India. Indian J Endocr Metab. 2018;22:67-73.

Borgohain B, Phukan P, Sarma K. Prevalence of osteoporosis among vulnerable adults residing in the northeastern region of India: A preliminary report from a tertiary care referral hospital. J Orthop Traumatol Rehabil. 2017;9:84-7.

Thulkar J, Singh S, Sharma S, Thulkar T. Preventable risk factors for osteoporosis in postmenopausal women: Systematic review and meta-analysis. J Midlife Health. 2016;7:108-13.

Kaur M. Prevalence and associated risk factors of osteoporosis in post-menopausal women in North India. Mal J Nutr. 2013;19:285-92.

Aggarwal N, Raveendran A, Khandelwal N, Sen RK, Thakur J S, Dhaliwal LK, et al. Prevalence and related risk factors of osteoporosis in peri- and postmenopausal Indian women. J Midlife Health. 2011;2:81-5.