Osteoporosis: A Big Problem

The next issue of The Medical Letter (September 29, 2014) will feature an article on Drugs for Postmenopausal Osteoporosis. In anticipation, it might be worthwhile to consider the scope of the problem, which may be the most common of all those we write about. The numbers here come from guidelines published by the American Association of Clinical Endocrinologists in Endocrine Practice 2010; volume 16: supplement 3.

About 8 million women in the US have osteoporosis. By the time they are 60 years old, 50% of white women in this country have osteopenia or osteoporosis. About 40% will develop fractures. The incidence of all of these is lower in Latina and African American women. Altogether, osteoporosis causes about 2 million fractures per year in the US, more than the number of cases of new strokes, heart attacks, and invasive breast cancer combined. The cost of those fractures is estimated to be about $17 billion for inpatient care, outpatient care, and long-term care. A substantial part of that expense is for hip fractures, which have a one-year mortality rate of 17% for women (and 30% for men). But even vertebral fractures are responsible for about 70,000 hospital admissions each year.

The number of people in the US who are more than 65 years old is expected to double by the middle of this century. At the moment, fewer than half of all women with postmenopausal osteoporosis are diagnosed, and only about 15% are treated for the disorder. So our work is cut out for us. Hopefully, the next issue of The Medical Letter will be helpful in getting it done.

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  1. William Bayer, MD says:

    I wonder how strong the argument for treatment is in African American women, since their rate of hip fracture is so low. My practice is mostly African American and I have prescribed alendronate frequently and in 20 years I have seen 4 hip fractures and 2 cases of osteonecrosis of the jaw.

  2. Larisa Bobr says:

    osteoporosis is lower in African American women and Vit D concentration is lower in African American people: how that correlate?

  3. David M. Schachter, MD says:

    How about older men? I am 73 yo w/severe osteoporosis and already 4 spinal compression fractures with very low bone density. Being treated with bisphosphonates, don’t know what to expect. Bent over, in pain, weak. Thanks for any words.

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