Osteoporosis: underrated, underdiagnosed and undertreated.
Osteoporosis is: (1) Underrated. Currently costs about 7 billion dollars annually in Australia. Has high morbidity and 2-3-fold increase in risk of death after any major osteoporotic fracture. Genetic factors contribute highly to risk, modified by lifestyle and hormonal factors. (2) Underdiagnosed. Bone density is a good predictor of subsequent risk. Anyone with a low-trauma fracture has osteoporosis unless proven otherwise. Every individual with a low trauma fracture should be investigated for exclusion of underlying osteoporosis and considered for effective treatment to reduce future fracture risk. More than 75% of women and about 90% of men with a high likelihood of osteoporosis are not investigated. (3) Undertreated. More than 75% of those affected are not treated. Effective treatments (eg, hormone replacement therapy, selective oestrogen receptor modifiers and bisphosphonates) reduce fracture risk by 30%-60%. Simple measures like vitamin D and calcium supplementation and use of hip protectors can reduce hip fractures, particularly in institutionalised and housebound elderly people
Bone and Mineral Research Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.
Tuan V
TV
Nguyen
Jacqueline R
JR
Center
John A
JA
Eisman
D000368:Aged; D015519:Bone Density; D002136:Calcium, Dietary / Q000627:therapeutic use; D002762:Cholecalciferol / Q000627:therapeutic use; D003951:Diagnostic Errors; D004164:Diphosphonates / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control*; D020849:Raloxifene Hydrochloride / Q000627:therapeutic use; D012307:Risk Factors; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D017211:Treatment Failure
D002136:Calcium, Dietary; D004164:Diphosphonates; D020845:Selective Estrogen Receptor Modulators; D002762:Cholecalciferol; D020849:Raloxifene Hydrochloride