Osteoporosis epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2], Raviteja Guddeti, M.B.B.S.[3] Farman Khan, MD, MRCP [4]
Overview
Osteoporosis is a major health problem involving 43.9% (43.4 million) of male and female population in the United States. The disease rate increased as people's age raised. The most prevalent age group of patients is 80 years and older. White females and African-American males have the highest frequency among the other races.
Epidemiology and demographics
Incidence
Generally, all postmenopausal women and more than 50 years old men would experience the osteoporosis, to some extend.
The incidence of lifetime osteoporotic fracture, the most important outcome of osteoporosis disease, is approximately one out of every two women and also one in four men over 50 worldwide. More than 1.5 million fractures per year could be occurred secondary to osteoporosis; among which are 300,000 hip fracture, 700,000 vertebral fracture, 250,000 wrist fracture, and more than 300,000 other bones fractures.[1]
Prevalence
Upon the major epidemiological studies occurred in US, it is estimated that 10.3% (10.2 million) of more than 50 years old people in US are involved in Osteoporosis; which is based upon femoral neck BMDs only . However, based on BMD in either bone sites, it seems that 43.9% (43.4 million) of Americans have the disease.[2] In developed countries, the average prevalence of osteoporosis is 3871 per 100,000 patients. While osteoporosis occurs in people from all ethnic groups, European or Asian ancestry predisposes an individual to osteoporosis.[3]
Age
The prevalence of osteoporosis is increased with age in both genders. The highest rate of osteoporosis is found among people of 80 years and older, in both men and women; 35% of women and also 11% of men.[2] The mortality due to any complication of hip fracture is higher among men than women; while average age of men and women involved in osteoporotic fractures are differs. It means that the age is an important factor in the osteoporosis clinical symptoms and also outcome.[4]
Race
Osteoporosis usually affects individuals of all races. Through the Third National Health and Nutrition Examination Survey (NHANES III), large population was studied; finally, concluded that 20% of white post-menopausal women, 10% of Hispanic women, and just 5% of African-American women involved in osteoporosis (defined as T-score of less than -2.5). Taking the cutoff point used for women into account for men, the prevalence of osteoporosis become 4%, 2%, and 3% in white, Hispanic, and African-American men, respectively.[5]
Recently, hip fracture rate is decreasing in White women and increasing in Hispanic women.[6][7]
Increasing life expectancy in African-Americans and also Hispanics, the probability of fractures during lifetime would be higher. While the percentage of non-White people experiencing fracture was 12% in 2005, the percentage would be raised to 21% by 2025.[8]
The risk of osteoporotic fracture in Caucasian women and men, after age of 50, are 40% and 13%, respectively.[9]
Gender
Females are more prone to develop osteoporosis than men. Lifetime risk of fractures is three times more in women than in men, but men are associated with higher mortality rates than that of women. Meanwhile, the number of men who experience such low bone mass that would encounter them to greatest risk of fracture, are more lower than women. In fact, the percentage of men and women, who have bone mineral density (BMD) of lower than -2.5 SD below the mean for 20-29 years old women, are 4% and 20%, respectively.[10]
Regarding some of the age-dependent variations in the effects of gender on osteoporotic fractures, it seems that the some of the differences between men and women clinical features and outcome relied on age variety. Although the life expectancy reduction due to osteoporosis is the same between men and women, the proportion of lost years would be higher among men; reflecting that the hip fracture burden is more on men survival.[4]
References
- ↑ Masi L (2008). "Epidemiology of osteoporosis". Clin Cases Miner Bone Metab. 5 (1): 11–3. PMC 2781190. PMID 22460840.
- ↑ 2.0 2.1 Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S; et al. (2014). "The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine". J Bone Miner Res. 29 (11): 2520–6. doi:10.1002/jbmr.2269. PMC 4757905. PMID 24771492.
- ↑ Melton LJ (2003). "Epidemiology worldwide". Endocrinol. Metab. Clin. North Am. 32 (1): 1–13, v. PMID 12699289.
- ↑ 4.0 4.1 Trombetti A, Herrmann F, Hoffmeyer P, Schurch MA, Bonjour JP, Rizzoli R (2002). "Survival and potential years of life lost after hip fracture in men and age-matched women". Osteoporos Int. 13 (9): 731–7. doi:10.1007/s001980200100. PMID 12195537.
- ↑ Looker AC, Orwoll ES, Johnston CC, Lindsay RL, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP (1997). "Prevalence of low femoral bone density in older U.S. adults from NHANES III". J. Bone Miner. Res. 12 (11): 1761–8. doi:10.1359/jbmr.1997.12.11.1761. PMID 9383679.
- ↑ Brauer CA, Coca-Perraillon M, Cutler DM, Rosen AB (2009). "Incidence and mortality of hip fractures in the United States". JAMA. 302 (14): 1573–9. doi:10.1001/jama.2009.1462. PMC 4410861. PMID 19826027.
- ↑ Zingmond DS, Melton LJ, Silverman SL (2004). "Increasing hip fracture incidence in California Hispanics, 1983 to 2000". Osteoporos Int. 15 (8): 603–10. doi:10.1007/s00198-004-1592-7. PMID 15004666.
- ↑ Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007). "Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025". J. Bone Miner. Res. 22 (3): 465–75. doi:10.1359/jbmr.061113. PMID 17144789.
- ↑ Melton LJ (2000). "Who has osteoporosis? A conflict between clinical and public health perspectives". J. Bone Miner. Res. 15 (12): 2309–14. doi:10.1359/jbmr.2000.15.12.2309. PMID 11127196.
- ↑ Melton LJ, Orwoll ES, Wasnich RD (2001). "Does bone density predict fractures comparably in men and women?". Osteoporos Int. 12 (9): 707–9. PMID 11605734.