Osteoporosis: underrated, underdiagnosed and undertreated

Med J Aust. 2004 Mar 1;180(S5):S18-22.

Abstract

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

Publication types

  • Review

MeSH terms

  • Aged
  • Bone Density
  • Calcium, Dietary / therapeutic use
  • Cholecalciferol / therapeutic use
  • Diagnostic Errors
  • Diphosphonates / therapeutic use
  • Estrogen Replacement Therapy
  • Female
  • Fractures, Spontaneous / etiology
  • Fractures, Spontaneous / prevention & control
  • Humans
  • Male
  • Osteoporosis / complications
  • Osteoporosis / diagnosis*
  • Osteoporosis / drug therapy
  • Osteoporosis / prevention & control*
  • Raloxifene Hydrochloride / therapeutic use
  • Risk Factors
  • Selective Estrogen Receptor Modulators / therapeutic use
  • Treatment Failure

Substances

  • Calcium, Dietary
  • Diphosphonates
  • Selective Estrogen Receptor Modulators
  • Cholecalciferol
  • Raloxifene Hydrochloride