Epidemiology of Osteoporosis


Osteoporosis is the most common bone disease in humans. The Surgeon General estimates 2 million bone fractures happen in the US due to bone disease every year. About a third result in hospitalization. Fractures are often the trigger that results in people going into nursing homes. It’s estimated that 180,000 people (US) go into nursing homes soon after a fracture every year. The number of people with osteoporosis worldwide is thought to be over 100 million.

Experts project 40% of women over age 50 will experience a bone fracture at some point in their lifetimes. The US Agency for Healthcare Research and Quality says 52 million people in the US have low bone density - although most of these do not have osteoporosis. Further “an estimated 1 in 5 U.S. women over age 50 has osteoporosis.” The International Osteoporosis Foundation estimates that worldwide an osteoporotic break happens every three seconds. The average age of the population continues to increase, so experts project its prevalence will increase in coming decades.

According to the National Osteoporosis Foundation and the National Institutes of Health, if you are a woman over fifty, are small in stature and slight in build, are taking certain medications, or have a family history of osteoporosis, you are among the most likely to be one of the estimated ten million Americans today that have osteoporosis. If poor nutrition, prolonged inactivity, smoking, or excessive alcohol consumption are added to that list, your chances of developing osteoporosis increase. The majority of osteoporosis patients victims are postmenopausal women, but men and children are not beyond its reach. About one million (US) women and half a million men experience a compression fractures of the vertebrae every year.

The formation of bone mass begins in fetuses in utero and builds through childhood and adolescence, peaking sometime in the twenties. According to the NOF, 85 to 90 percent of peak bone mass forms by the age of 18 in females and by the age of 20 in males. With adequate nutrition and absent degenerative disease, healthy bone mass should provide stability well through young adulthood and beyond. At some point as age progresses however, the density of bone slowly begins to decline. Hereditary factors, as well as influences like lifestyle, medical conditions, and certain medications, affect the rate at which bone mass decreases.

Anything that interrupts the formation of healthy bone structure in a child, adolescent or young adult can lead to a predisposition for osteoporosis. Although rare, osteoporosis is found in young people, but is usually caused by a separate, underlying medical condition or the medication prescribed to treat that condition, as may be the case in juvenile rheumatoid arthritis, diabetes, or kidney disease.

Men are susceptible, too, although not at the same statistical rate as women. Of the ten million people Americans who suffer from osteoporosis today, two million are men. Bone loss in men generally begins later than it does in women with their bone density beginning to decline in their sixties or seventies instead of their fifties. But once bone mass does begin to decline in men, it appears to take place at the same rate as it does for women. Although men do not experience the same drop in estrogen levels than women do when they go through menopause, sarcopenia - muscle loss - seems to have a stronger connection to osteoporosis in men than women. Osteoporosis is often not diagnosed as readily in men as it is in women because its lower incidence has lead to less frequent medical screening. The first indication of osteoporosis in older men is usually a fracture.

The US Centers for Disease Control and Prevention say that 24.5 percent of American women past age 65 have osteoporosis, and 5.1 percent of men in the same age range.

people with osteoporosis Known also as a "silent disease," osteoporosis and its predecessor osteopenia are undetectable at first. The patient cannot feel the deterioration of bone mass; fractures often serve as the first confirming diagnosis. It is predicted that as the population ages, the incidence of osteoporosis in the United States and throughout the world will grow, making effective screening, diagnosis and prevention even more urgent.

Naysayers

In an article called "The myth of osteoporosis". Dr. Adriane Fugh-Berman was quoted as opining that "osteoporosis is not a killer disease. In fact, it’s not really a disease at all, but a structural abnormality."

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