Bones grow in size and strength until peak bone mass is attained around the age of 35 years. Peak mass varies between demographic subgroups (25-30% higher in males than females 10% higher in blacks than whites), although there is a large variation within each group (1 woman in 40 has a peak mass less than the average for women aged 65 years). Bone mass subsequently declines with age and as a result of a variety of factors that predispose an individual to bone loss. The observed bone mass of an individual over 35 years therefore represents their peak bone mass minus both the cumulative age-related bone loss and any losses resulting from disease or specific risk factors.
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