Guest Author - Denise Howard, M.D., M.P.H.

Osteoporosis is a condition in which the bone mineral density has become so low that minimal trauma can lead to a fracture or break in the bone. This condition affects a large number of people, both men and women. Those with Osteoporosis are at high risk of breaking their bones, especially their hip. This represents a major economic burden for the health care system and can be the one event that leads to permanent disability in older people.

The annual direct cost of osteoporotic related fractures is estimated to be $17-20 billion in the U.S. and $30 billion in the European Union. By 2040 this is estimated to be $50 billion in the U.S. The costs are greater than the health care cost of breast cancer, stroke and diabetes.

Approximately 8 million women in the United States have Osteoporosis and 200 million worldwide. 22 million people in the U.S. have low bone mineral density. By 2020 it is estimated that 14 million people in the U.S. over the age of 50 will suffer from this condition. Women are at greater risk than men. Race also plays a role. The table below summarizes the percentage of women by racial group over age 50 that are affected.

Osteoporosis Low bone mineral density
White&Asian 22% 52%
Black 5% 35%
Hispanic 10% 49%

Even though Asians tend to have lower bone density their risk of developing a fracture is no greater than Blacks or Hispanics. Even though Blacks are less likely to experience fractures, they are at greater risk of disability and death if they do experience a hip fracture.

Hip fractures are the most devastating consequence of Osteoporosis and typically occurs after a fall. The estimates for this are expected to reach 6.3 million by 2050. 20% of people die within the first year after experiencing a hip fracture. 33% require nursing home placement and less than 33% regain their previous level of physical fitness. Fractures can occur in other areas such as the spine. This can result in loss of height and chronic back pain. Of the people who experience fractures that are obviously due to fragile bones, less than 25% are evaluated for Osteoporosis.

Given the economic burden and risks of disability and mortality it is imperative that everyone become aware of this treatable and preventable disorder.

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