Abstract
It is likely that by 2044 biomedical and public health forces will be able to control bony fragility to a substantially greater degree than we have succeeded in doing today, but that demographic and lifestyle forces already at work will offset those gains, perhaps substantially. On the other hand, economic and social forces outside of our control will decrease the prevalence of skeletal fragility - harshly, I fear - either by strengthening old bones the ard way, or by decreasing the numbers of the elderly, or both. The final outcome will be the algebraic sum of the effects of these countervailing forces, which is impossible to estimate with any assurance. My guess is that osteoporosis will be less of a problem in 2044, though, unfortunately, for the wrong reasons.