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
Nguyen
Tuan V
TV
Bone and Mineral Research Program, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.
Center
Jacqueline R
JR
Eisman
John A
JA
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