Epidemiology of osteoporosis

Abstract

Osteoporosis is a skeletal disorder characterized by low bone mass and micro-architectural deterioration of bone tissue with a consequent increase in the fragility of bone and hence susceptibility to fracture.1 Historically, the term ‘osteoporosis’ first entered medial terminology in France and Germany in the nineteenth century, as a descriptive term emphasizing the porosity of the histological appearances of aged human bone. Prior to this, however, work published by Sir Astley Cooper suggested that certain types of fracture may occur due to age-related reduction in bone mass or quality.2 He described the original classical epidemiological hallmarks of these fractures: incidence rates that increase with age; rates which are higher among women than men; and fractures which are associated with only moderate trauma at sites containing large amounts of trabecular bone. These features are typified by fractures of the proximal femur, distal radius and vertebra, but fractures at other sites – such as the pelvis, proximal humerus, and proximal tibia – show similar patterns. These fractures are the serious and important outcomes of the condition and lead to severe mortality and morbidity, a significant burden on society in general, and a huge economic impact.3 Osteoporotic fractures alone cost the United States around $17.9 billion per annum, and the United Kingdom around £1.7 billion (Table 1).4Table 1