World Osteoporosis Day falls on the 20th of October. It forms the starter gate for a year-long campaign dedicated to raising global awareness of bone health and the prevention, diagnosis and treatment of osteoporosis and related musculoskeletal diseases.
Spearheaded by the International Osteoporosis Foundation, it unites global advocates in a common effort to put the spotlight on the disease and its burden, sparking media interest and global public outreach. Member societies, health care professionals, medical authorities, policymakers, and of course the patients themselves, use World Osteoporosis Day as an occasion to speak out and call for action.
Why current attitudes and lack of action remain unacceptable
Stated baldly, osteoporosis remains underdiagnosed and undertreated worldwide. Millions of people at high risk of bone fractures are often blissfully unaware of the underlying silent disease. The huge human and socioeconomic cost, and severe impact of fractures on patients’ independence and lifestyle, continues to be underestimated. World Osteoporosis Day is therefore a key opportunity to co-ordinate global and local efforts, and to work together to make as much noise as possible on and around October 20th each year.
The hard facts that affect everyone
- Osteoporosis affects over 500 million people worldwide. Worldwide, 1 in 3 women, and 1 in 5 men. Yet the vast majority remain undiagnosed and untreated.
- Fragility fractures due to osteoporosis can be devastating, leading to: chronic pain and disability; loss of independence; increased risk of further fractures; premature death.
- In addition, families, communities, and healthcare systems bear the enormous and costly burden of osteoporosis and related fractures.
- Osteoporosis treatment receives less attention and funding compared to cardiovascular disease management. Up to 80% of patients who suffer an osteoporotic fracture are neither diagnosed nor treated for underlying osteoporosis.
- Only a third of vertebral fractures come to clinical attention. Spine fractures are often misdiagnosed as simple ‘back pain’. Radiologists fail to recognise and report vertebral fractures on X-rays.
- There is low awareness among primary care physicians: osteoporosis is not prioritised in medical training, and there is inadequate knowledge of management guidelines.
The risk of bone loss due to certain diseases and medications is not always front of mind.
Need, nurture and nutrition
There is a great need for education about bone-healthy nutrition, along with sufficient physical exercise, and the importance of calcium and Vitamin D – all of which should be integrated into school curriculums, and reinforced through public education campaigns.
There should be greater investigation by doctors; screening and risk assessment in these patients should be integrated into routine primary care. Misconceptions about men and osteoporosis continue to result in low rates of diagnosis and treatment in men.
The fact that bone health is under-prioritised within healthcare systems is a key reason for the high treatment gap. For example, in Europe, on average, 72% of women at high risk of fracture do not receive treatment. The same holds true for a developing country like South Africa.
At a time when our understanding of osteoporosis has never been greater, when technology allows for risk identification and early diagnosis, when an extensive range of effective treatments is readily available – it is simply unacceptable that patients continue to receive inadequate care, as many professionals fail to prioritise bone health on the same level as cardiovascular disease or cancer.
Greater care can be taken
- Bone health is as important as cardiovascular health for healthy ageing. Take the time to screen your older patients for osteoporosis risk factors.
- Some disorders can lead to a greater risk of osteoporosis: rheumatoid arthritis, digestive tract diseases such as celiac disease, prostate or breast cancer, diabetes, chronic kidney disease, thyroid or parathyroid gland disorders, COPD, hypogonadism, prolonged immobility, and HIV.
- Women who experience early menopause are at greater risk of osteoporosis and benefit from early screening. Early treatments have been shown to reduce the risk of hip fracture up to 40%, and vertebral fractures by 30-70%
- Use of certain medications may also cause secondary osteoporosis. Among the most common: glucocorticoids (often known as ‘steroids’) used to treat inflammatory diseases.
- It’s sobering to realise that only 1/3 of vertebral fractures come to clinical attention. Radiologists should recognise the importance of identifying and reporting osteoporotic fractures.
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: www.osteoporosis.org.za
