Infrequent Zoledronate — Small Individual Gain, Larger Population Gain

Roughly half the women who have reached menopause have fragility fractures.1 Such fractures impose major burdens, such as complications, cost, and death. A variety of effective therapies are available, yet in general they are underused.2 The risk of fracture increases as bone mineral density decreases; however, although bone mineral density declines with age, the frequency distribution of bone mineral density values remains gaussian. Given this normal frequency distribution, most community-dwelling postmenopausal women have bone mineral density that is either indicative of osteopenia (T score of −2.5 to −1.0) or normal (T score of more than −1.0). Approximately 75% of fragility . . .