Bone strength and bone maintenance from femoral cross-sectional geometry in a Medieval Italian population (10th-12th centuries AD)

Bone loss has often been framed an inevitable aspect of aging and various studies have found sex- and age-based trends in bone maintenance and loss across modern, historic, and prehistoric populations. We present the results of femoral cross-sectional geometry in a rural Medieval Italian archaeological sample at the Pieve di Pava (n=92) in Southern Tuscany. The Pieve di Pava was a rural parish church located in the disputed area between the Diocese of Siena and Diocese of Arezzo during the Early Medieval Period and was continuously used from the 7th century BC through the medieval periods. Both sexes show an age expected increase in medullary area; however total area also increases with age and cortical area is therefore maintained, indicating that both males and females experience endosteal bone loss and periosteal bone apposition in the femur. Our results show no significant sex difference in medullary area, total area, or cortical area; both sexes maintain both strength (Zp and J) with increased age. These results suggest that bone loss in rural medieval populations may not accompany an overall decrease in bone strength, and that intensive physical activity associated with rural medieval lifestyle may help maintain bone strength in old age despite cortical bone loss. We discuss these results in the context of evidence for intraskeletal bone maintenance in this sample, and in other historic populations.