Review Article | Published:

Osteoporosis: impact on health and economics

Nature Reviews Rheumatology volume 6, pages 99105 (2010) | Download Citation

  • A Correction to this article was published on 01 April 2010

Abstract

Osteoporosis is a major public health problem through associated fragility fractures. The most common sites of fracture are the hip, spine and wrist, and these have an enormous health and economic impact. All fractures result in some degree of morbidity, but fractures at the hip are associated with the worst outcomes. The worldwide direct and indirect annual costs of hip fracture in 1990 were estimated at US$34.8 billion, and are expected to increase substantially over the next 50 years. Fracture incidence varies between populations, and is set to increase over coming decades as the global population becomes more elderly. This effect will be particularly marked in the developing world, which is additionally assuming more-westernized lifestyles that predispose to increased fracture risk. Strategies to target those at high risk of fracture have been developed, but preventative measures at the public health level are also urgently needed to reduce the burden of this devastating disease.

Key points

  • Osteoporosis-related fractures are very common, and are associated with high direct and indirect costs to the global economy

  • Hip and vertebral fractures are associated with impaired quality of life and a 20% reduction in survival

  • The number of fractures will increase globally with the aging population, with much of the future burden falling on the developing world

  • New case-finding strategies, such as FRAX®, offer the potential to improve the targeting of individuals most at risk

  • Studies in developed populations have suggested modest reductions in the age-adjusted and gender-adjusted rates of osteoporosis-associated fracture

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Affiliations

  1. The MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK

    • Nicholas Harvey
    • , Elaine Dennison
    •  & Cyrus Cooper

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Competing interests

The authors declare no competing financial interests.

Corresponding author

Correspondence to Cyrus Cooper.

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DOI

https://doi.org/10.1038/nrrheum.2009.260

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