Nov. 18, 2025
Jane A. Cauley’s Impact on Bone Health and Aging
Her work on osteoporosis treatments has expanded the potential for keeping bones healthy while aging, especially for women.
TOPICS: People
Designs on Aging-Ready
By Parmitha Chanduri
It would be fair to say that Jane A. Cauley wrote the book on aging research. Indeed, “The Epidemiology of Aging,” published in 2012, is one of several to which Cauley has contributed, along with works on “Bone Density and the Risk of Breast Cancer” and “Osteoporosis.” In addition, she's written approximately 1,000 scientific papers and 30 book chapters during a career spanning some 40 years in academic research.
“The ultimate capstone of a career in epidemiology is if your work leads to testing treatments,” says Anne Newman, Distinguished Professor emerita and former chair of epidemiology, University of Pittsburgh School of Public Health. “And she's not only identified key risk factors but done the studies to figure out the best prevention for osteoporosis. She's done it all.”
Cauley, Distinguished Professor emerita, joined Pitt’s Department of Epidemiology as a research associate after completing her doctorate in public health in 1983 at Pitt at what then called the Graduate School of Public Health. Before her 2025 retirement, she held positions as vice chair of research, executive vice chair and interim chair of the epidemiology department.
Most of her work was in osteoporosis, the disease in which bones lose density and mass, becoming brittle and more easily broken.
Osteoporosis occurs in both sexes and increases as people age. According to the National Institute on Aging, osteoporosis affects about one in five women and about one in 20 men over 50. Risk is heightened for non-Hispanic white, Asian or fine-boned women, those with a family history of the disease, and people with diabetes, rheumatoid arthritis or human immunodeficiency virus.
“Osteoporosis is a ‘silent’ disease that rarely has symptoms,” says Cauley, explaining that people may not know they have it until a bone breaks. For those with osteoporosis, even coughing, bending or lifting an item may lead to a break. “Some people think of epidemiology as just looking for risk factors, but the reason to look for risk factors is to identify what you can change to improve health,” says Newman.
“And [Cauley's] not only identified key risk factors but done the studies to figure out the best prevention for osteoporosis. She's done it all.”
Anne Newman, Distinguished Professor emerita and former chair of epidemiology
Cauley played key roles in randomized clinical trials that helped to establish the efficacy of the drug aldendronate—better known as Fosamax—as an osteoporosis treatment. She also was involved in studies of other drugs like Reclast (risedronate) and the estrogen receptor modulator raloxifene, marketed as Evista, which are alternatives to Fosamax.
“At the time, the only medicine approved for osteoporosis was hormone therapy with salmon calcitonin, which didn’t work very well,” she says. “When Fosamax got approved in 1998, it was really exciting to be on the forefront of discovering new options for treatment for women with osteoporosis.”
Cauley was a coprincipal investigator of the landmark Women’s Health Initiative (WHI), a nationwide study funded by the National Heart, Lung, and Blood Institute that began in the early 1990s and concluded in 2005—making it the largest women’s health prevention study ever conducted, with more than 161,000 women enrolled in 40 clinical locations.
The wide-ranging WHI studied strategies for prevention of cardiovascular disease, cancers and osteoporotic fractures. It produced key findings, including that combined estrogen and progestin pills taken for menopausal symptoms did not prevent heart disease in women after menopause. The follow-up of participants has continued to yield insights, like calcium and vitamin D supplementation does not prevent fractures in postmenopausal women. (Cauley served as a chair of the Calcium Vitamin D Committee for the trial’s duration.)
“Working with the WHI was really rewarding,” she says, acknowledging that even the study's well-documented missteps provided valuable learning opportunities for further studies. She is currently principal investigator of an ancillary WHI study examining the relationship of sleep to falls and fractures.
“She's always been very devoted to the cause of science with no hubris whatsoever,” says Roberta Ness, a former Department of Epidemiology chair. “She has two daughters, both of whom are in public health—and that says a lot.”