'Men do get it, but it's mostly women,' Dr. Shaw said. 'It's a silent disease so the key is prevention and screening and being aware. Unfortunately, most of those who see me found out because of a fracture.'

Osteoporosis is a disease with a long name and a huge impact.

Half of all menopausal women over age 50 will find themselves facing the bone disease at some point, said Dr. Kevin Pe-Aung Khaw, a rheumatologist who treats osteoporosis at Portland's Adventist Medical Center.

"Men do get it, but it's mostly women," Dr. Shaw said. "It's a silent disease so the key is prevention and screening and being aware. Unfortunately, most of those who see me found out because of a fracture."

Osteoporosis occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break from a fall or even from sneezing or minor bumps. Osteoporosis means "porous bone."

Among the sufferers is the actress Sally Field, 69, who learned she had it when she was 59. Actress Blythe Danner, 73, has it too, and her daughter, Gwyneth Paltrow, 44, has osteopenia, or early bone loss often leading to osteoporosis.

The disease is common. More than 3 million American women discover each year they have osteoporosis, and some older men do too. There's no cure, but it can be managed with a healthy diet including calcium and Vitamin D, weight-bearing exercises, and by stopping smoking, minimizing alcohol, slimming down and sometimes taking medications.

The disease is often discovered when a person suffers a "fragility fracture," of a wrist, hip or spine with a slight fall or even simply while standing, Dr. Khaw said.

"For treatment, we focus on two broad approaches: non-pharmacologic (not taking prescription medicine), or using prescription medicine in selective cases."

Simple steps can help.

"Walking is great," Dr. Khaw said. "And also take practical steps to prevent falls: put night lights on steps or in the hall, take precautions when you step outside in rainy, wintry weather."

Those natural steps, however, won't prevent the gradual loss of bone that happens with aging, said Providence Medical Center's Dr. Michael McClung, an internationally recognized expert in the disease.

"It especially won't prevent the loss of bone that happens in the first several years after menopause," he said. "There are some patients who are at high enough risk for fracture that pharmacological steps should be taken."

Drugs can help prevent spine and hip fractures, he said by phone from Wisconsin. He is between trips lecturing on osteoporosis in Brazil, Australia, South Korea and Saudi Arabia.

One of Dr. Khaw's patients, Marilyn Reihs, 78, of Portland, said her regimen of Fosamax and Prolia has prevented fractures and built up her bone density. A survivor of breast cancer, she said she dutifully walks two miles every day, makes sure she has proper calcium and Vitamin D and takes the medicine. She's had no fractures or other ill effects of osteoporosis, she said.

Osteoporosis most often occurs in older women, most commonly those who have reached their 80s, Dr. McClung said. "At age 65, maybe 20 percent have osteoporosis, and fewer at younger ages."

Older folks don't recover well from injuries, Dr. Khaw said. "People actually can die as a complication, and there is the possibility of disability and nursing homes."

All women and some men should be screened after age 65 — even if they have no symptoms — and younger women who smoke or drink alcohol excessively should be screened sooner, Dr. Khaw said. So should those with a family history of the disease.

Reihs said her regime has kept her well in the 10 years since she learned she had osteoporosis. "No jaw pain, no symptoms," she said by phone Hawaii where she was vacationing. "I'm a survivor."

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