Osteoporosis
Worldwide, the lifetime risk for a woman to have an osteoporotic fracture is 30-40%.1 Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue, which leads to increased bone fragility and risk of fracture, particularly of the hip, spine and wrist.2 The number of hip fractures worldwide due to osteoporosis is expected to rise three-fold by the middle of the next century, from 1.7 million in 1990 to 6.3 million by 2050.3 After menopause, 30% of women develop osteoporosis.4 Perhaps this increased risk with age contributes to the common misconception that osteoporosis is an "old woman's disease." The truth is that bone loss in women can begin as early as age 25.5 As the disease progresses, osteoporosis sufferers often lose several centimeters in height (10-15 cm. is not unusual) because the vertebrae in their spine begin to collapse.6 They also "dowager's hump," the characteristic curvature of the spine that can be seen in women of post-menopausal age.7 Many break their hip, and a startling 15% of those who suffer this common osteoporotic injury die as a result of complications such as pneumonia, other infections and cardiac insuffiency, mostly within the first six months following the fracture.8 Osteoporosis is a widespread public health problem, which results in staggering costs to national healthcare systems from osteoporosis-related hospitalization.9 For example, annual direct medical costs to treat 2.3 million osteoporosis fractures in Europe and the United States add up to US $27 million.10 In several European countries, osteoporosis is responsible for more hospital days for women over age 45 than any other disease.11 And, every 30 seconds, someone in the European Union sustains a fracture as a result of osteoporosis.12 Yet, despite all of these
facts, it wasn't until 1992 that medical doctors upgraded osteoporosis from being viewed as a "clinical condition" to being identified as a progressive systemic disease characterized by low bone mass and deterioration of bone tissue leading to bone fragility and fracture.13 Ignorance about osteoporosis is still common among health professionals, patients and the public at large. However, organizations do exist that are devoted to extensive education and communication programs which will increase understanding of bone physiology and osteoporosis while raising public awareness of major risk factors, prevention and management of the disease.14
The World Health Organization does make some general recommendations to the public regarding osteoporosis. They advocate a physically active lifestyle with some time regularly spent outdoors, a balanced diet with a calcium intake of at least 800-1500 milligram per day in children and adults, and a reduction of smoking and high alcohol consumption.15 Smoking cigarettes is one of the most avoidable risk factors associated with loss of bone density. Current smokers lose bone at faster rates than non-smokers, and by age 80 this can translate into 6% lower bone mineral density. Studies have also shown that the risk of hip fracture among smokers is greater at any age but rises from 17% greater at age 60 to 71% at age 80 to 108% at age 90.17
Actions, Information & Opportunities to Help There are many websites -- both comprehensive and single-issue -- dedicated to informing and analyzing issues related to osteoporosis. Also listed below are resources that offer help, theoretical sociological works, cultural studies, and multiple published news articles and campaign information pieces.
1International Osteoporosis Foundation (IOF).2Osteoporosis Online, definition.3World Health Organization, (WHO) 1999.4The Endocrine Society Patient Fact Sheet, 2000.5IOF (as cited above)6Ibid.7Ibid. 8Ibid. 9WHO (as cited above)10Ibid.11"Summary Report on Osteoporosis in the European Community - Action for Prevention." European Communities/European Foundation for Osteoporosis (EFFO, IOF), 1998.12IOF (as cited above)13WHO (as cited above)14Ibid.15Ibid. 16Law, M.R. and A.K. Hackshaw. "A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect." BMJ: 315:841-6, 1997.17Ibid.
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