The population-based prevalence of osteoporotic vertebral fracture and densitometric osteoporosis in postmenopausal women over 50 in Valencia, Spain (the FRAVO study)

Abstract

Purpose: To estimate the prevalence of vertebral fracture and densitometric osteoporosis in postmenopausal women over the age of 50 in Valencia, Spain.

Methods: This cross-sectional study was conducted in 2006-2007. An age-stratified population-based random sample of 824 postmenopausal women over the age of 50 answered a questionnaire and received a densitometric examination of the lumbar spine and hip with dual-energy X-ray absorptiometry and a lateral X-ray of the thoracic spine and lumbar regions. Osteoporosis was defined as a T-score less than or equal to -2.5 compared to a population of young women, and the presence of vertebral fractures was classified according to Genant's semiquantitative method.

Results: The average age of the women was 64 years (range 50-87 years). The prevalence for all vertebral fractures was 21.4% (95% CI: 17.7%-25.1%) and 9.7% (95% CI: 6.7%-12.7%) for moderate-severe fractures. In women over the age of 75, the respective values were 46.3% (95% CI: 34.2%-58.3%) and 23.9% (95% CI:13.6%-34.2%). Only 1.5% of the women with vertebral fractures were aware of their condition. The prevalence of osteoporosis was estimated as 27.0% (95% CI:23.1%-30.8%) for the lumbar spine, 15.1% (95% CI:11.7%-18.5%) in the femoral neck, and 31.8% (95% CI:27.8%-35.7%) at either sites.

Conclusions: The study confirms that osteoporosis (1 in 3 women over the age of 50) and vertebral fracture (1 in 5 for all fractures and 1 in 10 for moderate-severe fractures) constitute a major public health and healthcare challenge; measuring their real impact will depend in part on the criteria used to define a fracture.