Osteoporosis and paleopathology: a review

Osteoporosis is a complex and heterogeneous disorder, of multi-factor aetiology. It is the most frequent metabolic bone disorder, affecting an increasing number of post-menopausal women and aging individuals from both sexes. Although first recognized more than 250 years ago, the clinical and epidemiological knowledge about osteoporosis is largely limited to the last 70 years. Within the conceptual frames of paleopathology, disease is necessarily perceived in a space without depth (the skeleton) and of coincidence without development (the crucial moment of death) -but is also interpreted in a time interval which adds an historical gaze to its "biography". The study of osteoporosis in past populations (which faced sociocultural conditions utterly different from the genus vitae experienced by modern communities) supplements diachronic depth to the knowledge about bone modifications related to age, menopausal status or lifestyle. This article aims to provide a comprehensive record on the history of osteoporosis and fragility fractures as perceived by the biomedical, historical and, particularly, paleopathological sciences. As such, the main focus of this review is to present an exhaustive and historical-framed exposition of the studies of osteoporosis, bone loss and associated fractures within the field of paleopathology and, to a lesser extent, in the history of medicine. A biomedical-oriented synopsis of the main operational definitions, etiological agents and epidemiological features of osteoporosis and osteoporotic fractures is also provided.