Chapter 21 – Magnitude and Impact of Osteoporosis and Fractures

TLDR: Osteoporosis is a complex, multifactorial chronic disorder, in which a variety of pathophysiologic mechanisms lead to a progressive reduction in bone strength and an increased risk of fracture.

Abstract: Publisher Summary The purposes of this review are to summarize epidemiologic data concerning the frequency of osteoporosis and osteoporosis-related fractures, and to determine the impact that the condition has on society. Osteoporosis is a complex, multifactorial chronic disorder, in which a variety of pathophysiologic mechanisms lead to a progressive reduction in bone strength and an increased risk of fracture. Although viewed for many years as a major public health problem, the exact burden posed by osteoporosis is only now being rigorously assessed. Whether the disorder is defined by low bone mass or by the occurrence of specific fractures, osteoporosis is clearly a common condition. Thus, a third of postmenopausal white women in the United States can be expected to have osteoporosis in the lumbar spine, proximal femur, or midradius at any point in time, while the lifetime risk of a hip, spine, or distal forearm fracture from age 50 years onward in this group approaches 40%. However, the relative absence of symptoms until fractures occur makes effective therapeutic intervention difficult to implement. The public health burden will worsen dramatically in future decades, and the evaluation of strategies to prevent these fractures, both in individuals and in populations, has become an urgent priority.