Osteoporotic bone fractures and age-related bone loss in males inhabiting the Kujawy region in north-central Poland from the Neolithic to early modern times

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The current increase in the incidence of osteoporosis and osteoporotic fractures among men and the decrease in age in which these first occur raise the question about historical changes in the patterns of bone loss with age, including sex differences, and their biological and cultural determinants in the past. The present study analyzed bone mineral density (BMD) and bone fractures in 267 male skeletons representing six geographically homogeneous populations from the region of Kujawy in north-central Poland, both prehistoric (Middle Neolithic) and historical (early Middle Ages to early modern times). Sex differences in BMD were investigated using data from a previous study of females from these populations (Spinek et al., 2016). In general, the regular patterns of age-related bone loss found in men from the studied archaeological populations were similar to those observed today. In all age groups, Neolithic men showed a significantly higher BMD as compared to the historical samples; on the other hand, the latter revealed similar values to contemporary populations in the middle and old age groups. Thus, in the analyzed period, a major transition in bone maintenance patterns occurred between the Neolithic and the Early Middle Ages. The archaeological populations exhibited a faster rate of bone loss with age: while their initial BMD levels were higher than those in contemporary populations, BMD for the oldest age groups was similar to or even lower than today. The most pronounced sex differences in BMD were found for young adults, which indicates a significantly greater influence of factors limiting peak bone mass and contributing to bone loss in young women, probably associated with reproductive history (age at menarche and pregnancies). The men, and especially young individuals, exhibited a higher prevalence of osteoporotic fractures as compared to the women. The main factor determining such sex- and age-specific patterns of osteoporotic fractures in the analyzed skeletal samples was the generally greater susceptibility to injuries of the males.