**5. Conclusions**

In conclusion, in post-menopausal women aged 50–89 years without a diagnosis of osteoporosis, an estimated 21.4% had osteoporosis and 51.2% had osteopenia. More precise BMD measurements are recommended in individuals exhibiting TST ≤ 1.30 and BMI ≤ 23.4, TST ≤ 1.32 and BMI ≤ 22.4, TST ≤ 1.34 and BMI ≤ 21.6, or TST < 1.24 and any BMI in general health exams towards improving healthy life expectancy in community dwelling older adults.

**Author Contributions:** S.I. and J.T. designed the study and wrote the manuscript. R.O. and S.I. performed the data analysis and wrote the manuscript. H.H. and R.T. provided clinical experience and wrote the manuscript. H.K. and J.T. supervised the whole study. All authors have read and agreed to the published version of the manuscript.

**Funding:** This work was supported by a gran<sup>t</sup> from the Japan Orthopaedics and Traumatology Research Foundation, Inc. (number: 339) as well as research funds from the Promotion Project of Education, Research, and Medical Care from Shinshu University Hospital, the Japanese Orthopaedic Association, the Japanese Society for Musculoskeletal Medicine, the Shinshu Public Utility Foundation for Promotion of Medical Sciences, and The Nakatomi Foundation.

**Institutional Review Board Statement:** This study was approved by the investigational review board of our hospital (approval number: 2792). Written consent was obtained from all participants. All research was conducted in accordance with the STROBE guidelines for observational research.

**Informed Consent Statement:** Informed consent was obtained from all subjects involved in the study. Written informed consent has been obtained from the patients to publish this paper.

**Data Availability Statement:** The complete database of the cohort can be accessed at the Zenodo repository (doi.org/10.5281/zenodo.4722536).

**Acknowledgments:** We thank Hironobu Sato of the Obuse Town Institute for Community Health Promotion, Takashi Igarashi of the Center for Clinical Research at Shinshu University Hospital, and the Obuse town office for sample selection in this study.

**Conflicts of Interest:** The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
