Osteoporosis is a condition of bone deterioration commonly seen in middle-aged and elderly individuals that is the result of calcium loss. This condition is more common in women as it is often related to childbirth and lactation in addition to a poor or calcium deficient diet. This condition unfortunately frequently leads to broken hips associated with falls in elderly individuals. Although the bone loss of osteoporosis does not directly affect a person's mental state, its indirect effects can be debilitating; depression, lack of self-esteem, and lack of confidence which can set up "vicious cycle" of physical and mental decline. Calcium supplements and proper diet can prevent osteoporosis. Other suggestions for prevention include avoiding under-nutrition (extreme weight-loss diets and eating disorders), maintaining proper vitamin D levels, engaging in regular weight-bearing activity, and not smoking/drinking to an extreme.