Jane A. Cauley: A career in caring
By Michele Dula Baum
It would be fair to say that Jane Cauley, DrPH, MPH, 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, MD, MPH, Distinguished Professor emerita and former chair of epidemiology, 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 the Department of Epidemiology faculty as a research associate after completing her doctorate in public health at the then—Graduate School of Public Health in 1983. Before her 2025 retirement, she'd hold positions as vice chair of research, executive vice chair and interim chair of the department.
"Most of my work has been in osteoporosis," Cauley says of 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 until a bone breaks.
It doesn't take much, either. A minor fall that wouldn't affect a healthy bone can fracture a bone 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.
Heard of alendronate? It's better known as Fosamax. Cauley played key roles in randomized clinical trials that helped to establish the drug’s efficacy as an osteoporosis treatment. How about other drugs like Reclast, risedronate or the estrogen receptor modulator raloxifene that are alternatives to Fosamax? Marketed as Evista, raloxifene is used to prevent osteoporosis and as an adjunct treatment for breast cancer. Cauley was in on those studies, too.
“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, such as that 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.
A past president of the American Society for Bone and Mineral Research (ASBMR), Cauley has been regularly honored for her achievements, including a Distinguished Alumni Award from Pitt Public Health (2004), ASBMR's Shirley Hohl Service Award (2018) and Fellow Award from the Gerontological Society of America (2021). She has also been listed among highly cited female scientists for her investigations into the physical and psychological changes that take place during and after the menopausal transition, including differences in estrogen and cholesterol levels, bone density and risks of hip fractures. Her 2025 record (1,254 papers and more than 167,000 citations) rank her at No. 16 in the United States and 22 worldwide, according to Research.com.
"She's always been very devoted to the cause of science with no hubris whatsoever," says Roberta Ness, MD, MPH, a former Department of Epidemiology chair who left Pitt to become dean of the University of Texas School of Public Health and is now retired. "She has two daughters, both of whom are in public health—and that says a lot."