“What we saw and what those of us in the bone heath field have known
is that the burden of major osteoporotic factors is huge,” said lead
author Dr. Andrea Singer of MedStar Georgetown University Hospital
in Washington, DC, and clinical director at the National
More than five million people over age 50 in the U.S. have been
diagnosed with the bone-weakening disease osteoporosis, including
two percent of men and ten percent of women, according to the
Centers for Disease Control and Prevention.
“We really underestimate the importance of osteoporosis and
fracture, and people underestimate their own risk,” Singer told
She and her coauthors used inpatient data from more than 1000
Between 2000 and 2011, 4.9 million women over age 55 were
hospitalized for osteoporotic fracture of the hip, pelvis, arm, leg
or spine, compared to 3 million for stroke, 2.9 million for heart
attack and 700,000 for breast cancer.
Osteoporotic fractures accounted for more than 40 percent of the
hospitalizations, the researchers calculated, and led to an
estimated hospital cost of more than $5 billion per year.
Heart attack, stroke and breast cancer hospitalizations cost the
healthcare system $4.3 billion, $3 billion and $500 million per
year, respectively, according to results in Mayo Clinic Proceedings.
Even these numbers likely underestimate the true cost of
osteoporosis to the healthcare system, Singer said.
“We’ve known for a long time that osteoporotic fractures are the
source of a lot of expense and pain,” said Dr. Ethel S. Siris, past
president of the National Osteoporosis Foundation and director of
the Toni Stabile Osteoporosis Center of the Columbia University
Medical Center at New York-Presbyterian Hospital.
“Since this is something that has a higher burden than other things
that patients or providers worry about all the time like heart
attack, stroke and breast cancer, then we ought to be doing
something to ask the right questions,” Singer said.
A quarter of all people who suffer a hip fracture die within one
year, which is much higher than the other diseases included in the
study, she said.
“Of the 75 percent who remain alive, many lose their independence
and need assisted living,” Singer said. “A lot of times people fear
not necessarily dying, but being incapacitated, ending up in a
nursing home. Those statistics are daunting.”
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Most people who break a hip never return to their normal lives, said
Siris, who was not involved in the new study.
“Half the people who break a hip have previously broken something
else, and instead of looking at that as a red flag, those people
don’t get evaluated, they don’t get bone density tests,” she told
Reuters Health. “Somehow or other fractures are just not taken so
But recognizing and treating osteoporosis after that first fracture
could prevent more fractures later, Siris said.
That can include maintaining a healthy lifestyle to prevent or slow
bone loss, getting adequate calcium and vitamin D, and doing
weight-bearing muscle strengthening exercise. Even people who have
had a fracture already can do modified safe activities, and can take
care with proper footwear, avoiding steps, and avoiding carrying
heavy loads, and thereby prevent falls, Singer said.
“In terms of building new bones and really getting to the best bone
density level you can, that happens when you’re young,” but it’s
never too late to treat osteoporosis, Singer said.
Used correctly, bisphosphonate drugs can be very effective at
lowering fracture risk, Siris said.
“There’s little doubt of the benefit of treatment if you need it
overwhelmingly,” she said. “There are lots of good treatments.”
Older women may qualify for a bone density test, and should request
one after suffering a fracture over age 50, Singer said.
“I hope in some ways this paper serves as a call to action to
providers and empowers women to think about their own bone health,”
she said. “If their provider isn’t proactively asking, then they can
ask about it.”
SOURCE: http://bit.ly/1uh2Nkb Mayo Clinic Proceedings, online
December 13, 2014.
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