Down to the Bone: the growing worldwide prevalence of osteoporosis

It is currently estimated that over 200 million people worldwide suffer with this silent disease. The incidences are increasing because of the longer life expectancy of so many people in today’s world where medical advancements help us to stay alive and relatively healthy a lot longer.

But every upside has its downside…and osteoporosis is one. It is one thing to keep bones as sturdy and strong during our active lives, but because we are living longer, we have to take extra precautions and develop new lifestyle regimes to protect our bones from the inevitable wear and tear of long-term aging.

The real numbers

Osteoporosis is a serious disease that can lead to death, and it takes a huge personal and economic toll. In truth, more people suffer worldwide due to osteoporosis than many other diseases which receive far more attention.

  • In Europe, the disability due to osteoporosis is comparable to the disability caused by chronic diseases, such as rheumatoid arthritis, asthma and high blood pressure-related heart disease.
  • There are more people with osteoporosis issues than people with breast cancer or diabetes or prostate cancer. Approximately 30% of all postmenopausal women have osteoporosis, and 15 to 30% of men may develop the condition. At least 40% of these people will sustain hip, forearm and vertebral fractures.
  • Worldwide, there is an osteoporotic fracture approximately every 3 seconds, which equates to over 10 million fractures per year.
  • Osteoporosis is estimated to affect one-tenth of women aged 60; one-fifth of women aged 70; two-fifths of women aged 80, and two-thirds of women aged 90.
  • One in 3 women over the age of 50 will experience osteoporotic fractures, as will one in 5 men over the age of 50.
  • Overall, 61% of osteoporotic fractures occur in women. Nearly 75% of hip, spine and forearm/wrist fractures occur among patients 65 years or older.
  • A mere 10% loss of bone mass in the vertebrae can double the risk of vertebral fractures, and similarly, a 10% loss of bone mass in the hip can result in a 3 times greater risk of hip fracture.
  • By 2050, the worldwide incidence of hip fracture in men is projected to increase by 310% and 240% in women, compared to rates in 1990.

Making old bones

In women over 45 years of age, osteoporosis accounts for more days spent in hospital than many other diseases. Evidence suggests that many women who sustain a fragility fracture are rarely appropriately diagnosed and treated for probable osteoporosis. This means that a great majority of individuals at high risk (possibly 80%), who have already had at least one osteoporotic fracture, are neither identified nor treated.

Unfortunately, a survey conducted in 11 countries, showed denial of personal risk by many postmenopausal women. There is a lack of discussion with their medical practitioner, and very often the first real attention is paid only once a fracture has taken place. There is a disturbing lack of diagnosis and treatment of the disease before it becomes serious.

In addition, the continual increase in global populations is going to result in greater evidence of osteoporosis, particularly across underdeveloped countries. The incidence of hip fractures are predicted to increase fourfold worldwide within the next 50 years. The costs of this disease will place enormous, untenable pressure on the health systems of these countries. Unless decisive steps for preventive intervention are taken now, it seems that a global osteoporosis epidemic of devastating proportions may engulf our health systems.

What should be done?

We should begin with ensuring greater information about the disease. The fact that it is known as the ‘silent’ disease is not helpful. Education should begin in the school years as to the prevalence and danger of the condition – and that it is not necessarily a decline associated only with old age. The seeds of osteoporosis can often be tracked back to lifestyle, along with age and genes.

Nevertheless, osteoporosis is both preventable and treatable before fractures occur. But because there are no warning signs prior to a fracture, many people are not being diagnosed in time to receive effective therapy during the early phase of the disease. Measures for prevention and control of osteoporosis are affordable and available:

  • Universally, all individuals over the age of 50 should undergo a bone density test or vertebral imaging to establish a patient’s fracture risk. All postmenopausal women and men aged 50 years and above should be evaluated for osteoporosis risks.
  • The Institute of Medicine (IOM) recommends a daily intake of 1000 mg/day of calcium for men aged 50–70 years and 1200 mg of calcium for women aged over 50 years and men aged over 70 years.
  • An adequate intake of calcium and Vitamin D are fundamental in the preventative years. Vitamin D is vital for the absorption of calcium.
  • Regular exercise, particularly weight-bearing, is vital for strengthening muscles, bone health, and balance. Exercises help slow bone loss due to disuse, and have a great benefit in preventing falls, the chief cause of fractures. Even walking 30 to 40 minutes every day, together with posture exercises, can be beneficial in preventing bone loss, and ultimately falls.
  • The cessation of smoking and alcohol consumption is crucially important, as both are found to contribute to the onset of thinning bones – even too much caffeine can be detrimental.
  • As people get older, they should also be aware of the effects of some medications, ensuring their meds are not likely to cause confusion and therefore loss of balance.

Every day there is more and more reason to love your bones!

NOFSA (National Osteoporosis Foundation South Africa)

NOFSA is the only non-profit, voluntary health organisation dedicated to promoting lifelong bone health. We focus on reducing the widespread prevalence of osteoporosis while working to find a cure for the disease, and by supporting research and developing programmes of education and advocacy.

Find out more about our work at: https://osteoporosis.org.za/www.osteoporosis.org.za

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