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Review
. 2020 May 15;133(1):105-117.
doi: 10.1093/bmb/ldaa005.

The epidemiology of osteoporosis

Michael A Clynes  1 , Nicholas C Harvey  1 , Elizabeth M Curtis  1 , Nicholas R Fuggle  1 , Elaine M Dennison  1 , Cyrus Cooper  1
Affiliations
Review

The epidemiology of osteoporosis

Michael A Clynes et al. Br Med Bull. .

Abstract

Introduction: With a worldwide ageing population, the importance of the prevention and management of osteoporotic fragility fractures is increasing over time. In this review, we discuss in detail the epidemiology of fragility fractures, how this is shaped by pharmacological interventions and how novel screening programmes can reduce the clinical and economic burden of osteoporotic fractures.

Sources of data: PubMed and Google Scholar were searched using various combinations of the keywords 'osteoporosis', 'epidemiology', 'fracture', 'screening', `FRAX' and 'SCOOP'.

Areas of agreement: The economic burden of osteoporosis-related fracture is significant, costing approximately $17.9 and £4 billion per annum in the USA and UK.

Areas of controversy: Risk calculators such as the web-based FRAX® algorithm have enabled assessment of an individual's fracture risk using clinical risk factors, with only partial consideration of bone mineral density (BMD).

Growing points: As with all new interventions, we await the results of long-term use of osteoporosis screening algorithms and how these can be refined and incorporated into clinical practice.

Areas timely for developing research: Despite advances in osteoporosis screening, a minority of men and women at high fracture risk worldwide receive treatment. The economic and societal burden caused by osteoporosis is a clear motivation for improving the screening and management of osteoporosis worldwide.

Keywords: epidemiology; fracture; osteoporosis.

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Conflict of interest statement

Conflict of interest statement:

The authors have no potential conflicts of interest.

Figures

Figure 1
Figure 1. Number of men and women at high fracture risk in 2040 relative to 2010, by world region. (With permission from Oden et al, Osteoporosis International 2015 ).
Figure 2
Figure 2. Trends in hip fracture worldwide over time: annual change in age- and sex-adjusted hip fracture incidence (Reproduced with permission from Cooper et al, Osteoporosis International 2011 )
Figure 3
Figure 3. Hip fracture rates for men and women combined in different countries of the world, categorised by risk. Countries are coded red (annual incidence >250/100,000), orange (150-250/100,000) or green (<150/100,000) where estimates are available. (Reproduced with permission from Kanis et al, Osteoporosis International 2012 )
See this image and copyright information in PMC

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