Osteoporosis: This dimineralization and bone loss occurs in nearly half of people over age 50 and is associated with fractures of the vertebrae, hips and wrist. The first presentation is with a fracture. Risk factors include history of a fracture under age 50, being female, being small and thin, Vitamin D deficiency, cigarette smoking, alcohol abuse, and caucasian and asian descent. Treatment with calcium, vitamin D, exercise, and medications: fasamax, actonel, boniva, and evista.