CONSUMER BACKGROUNDER

EMBARGOED: WEDNESDAY, OCTOBER 20, 2021

                                                 

About poor bone health, osteoporosis & osteopenia

About osteoporosis

  • Osteoporosis is a disease that leads to reduced bone strength and increased risk of fracture.1

  • Osteoporosis occurs when bones lose density and quality, leading to weakness of the skeleton.1 Once a fracture occurs, action must be taken to protect bone health, and the level of bone density is monitored to gauge improvement.

  • Particular risk factors place people at higher risk of developing osteoporosis.

  • Patients may not find out they have osteoporosis until after a first fracture.1

  • Any bone can be affected by osteoporosis, however fractures most often occur in the hip, spine, arm, wrist, ribs, legs and pelvis.1

  • Fractures are expensive to treat and disruptive to the lives of patients and their families.3

  • Data shows 22 per cent of people over 50 with poor bone health have osteoporosis.3

 

About osteopenia (low bone density)

 

  • Osteopenia is low bone mineral density defined by a Bone Density Test result between normal and osteoporosis.4

  • Not every person diagnosed with osteopenia will develop osteoporosis.4

  • Fractures in people with low bone density (osteopenia) are common.5 Once a fracture occurs, action must be taken to protect bone health, and the level of bone density is monitored to gauge improvement.6 

  • Of those aged over 50 with poor bone health, 78 per cent have osteopenia.3

 

Risk factors for poor bone health 

Risk factors for poor bone health include: 

  • Minimal trauma fracture in adults aged over 50 years (from tripping or falling).7

  • Family history of osteoporosis (or a broken hip).2,8

  • Medical risk factors, including coeliac disease, early menopause, low testosterone, rheumatoid arthritis, corticosteroid treatment (for longer than three months), overactive thyroid or parathyroid conditions, treatment for breast or prostate cancer, chronic kidney or chronic liver disease, and epilepsy treatment.2,8 Age and sex are also taken into account.  

  • Lifestyle risk factors, including poor calcium intake, vitamin D deficiency (from limited sunlight exposure), smoking, excessive alcohol intake and physical inactivity.2

 

Bone density test  

  • A bone density test is a simple scan that measures the density of the bones, usually at the hip and spine, and requires a GP referral.9

  • A bone density scan will determine if bones are in the range of osteopenia, or osteoporosis.9 

  • A scan takes 10-15 minutes, during which the patient remains fully clothed as the arm of the machine passes over the body.9

  • People over 50 years of age with risk factors for osteoporosis need a bone density scan.       


About fractures

  • More than 173,000 fractures in Australia were estimated to have occurred in 2020.

  • Fractures can require ambulance, emergency services, surgery, hospital stays, rehabilitation and home care.3

  • People who sustain a fracture from poor bone health are two-to-four times more likely to sustain a further fracture.3,10

  • Fractures due to poor bone health can severely disrupt normal life. Patients are commonly unable to work, drive, shop, complete household tasks, and have reduced mobility.1

  • Spinal fractures can lead to loss of height, changes in posture, and deformity of the spine.1

  • Only 20 per cent of women, and an even smaller percentage of men who sustain a minimal trauma fracture, are investigated for poor bone health. The healthcare system is treating the fracture and missing the underlying cause.11  

  • Two-thirds of spinal fractures (vertebral fractures) are not diagnosed or treated, even though nearly all cause pain and some disability.7

  • The burden of osteoporosis not only affects those living with the disease, but also their families, and the community at large.1


Key statistics 

  • More than 1.2 million Australians are living with osteoporosis, and the prevalence is on the rise.12

  • Studies demonstrate osteoporosis-related fractures are costly to the Australian healthcare system, at more than $3 billion per year.

  • Data shows 66 per cent of people over 50 years of age have poor bone health (osteoporosis or osteopenia).3

  • It is estimated that a bone will be broken every 3.4 minutes due to poor bone health.13  

  • People who have sustained a spinal fracture are four-times more likely to experience another fracture within 12 months, compared with those who have never sustained an osteoporotic fracture.10,14

  • Those at a heightened risk of osteoporosis may be unaware that risk factors, including a prior fracture, family history of fracture, low weight, smoking, early menopause and high alcohol intake increase their chance of further fracture.14

  • Only 20 per cent of women, and an even smaller percentage of men who come to medical attention with a fracture, are then investigated and treated to prevent further fractures.11                            

  • Targeted identification and management of patients’ post-fracture may reduce the risk of refracture by 80 per cent.15 

Morbidity & mortality

  • Fractures are associated with increased risk of death – approximately 3,489 deaths in Australia per year (mainly among the over 70s).3

  •  Hip fractures are most severe in terms of ongoing pain, disability and mortality.1

  •  Following a hip fracture in Australia, 11 per cent of patients are discharged to residential care, and up to six per cent of cases result in death.7

 

Impact on quality of life

  • The effects on quality of life include loss of independence, chronic pain, disability, emotional distress, lost productivity, reduced social interaction, and self-limitation caused by a fear of falling.1                                                                                

Prevention

  • Lifestyle changes that may reduce the risk of developing osteoporosis include not smoking, limiting alcohol consumption, getting an adequate calcium intake and sufficient vitamin D.2

  • Regular exercise (weight bearing and resistance combined) helps to strengthen bones and muscles, and prevents falls.15

 

Treatment

  • Treatment can reduce fracture risk by up to 50 per cent.8 

  • Early diagnosis and treatment can help prevent fractures and slow the progression of osteoporosis.7

  •  Osteoporosis is generally managed with medication and other changes that help support treatment e.g. weight-bearing exercise, adequate dietary calcium intake, adequate vitamin D (sunshine), or supplements as required.7

 

For more information about poor bone health, osteoporosis or osteopenia, visit www.healthybonesaustralia.org.au.

 

References

  1. Australian Institute of Health and Welfare (AIHW), Australia's health 2010. 2010.

  2. Osteoporosis Australia. Risk factors. 2017 [cited December 2020]; Available from: https://www.osteoporosis.org.au/risk-factors.

  3. Abimanyi-Ochom, J., J. Watts, and K. Sanders, Osteoporosis Costing all Australians. A New Burden of Disease Analysis 2012-2022. 2013.

  4. Osteoporosis Australia, What you need to know about Osteoporosis: Consumer guide. 2014.

  5. Harvard Medical School. Osteopenia: When you have weak bones, but not osteoporosis. 2020 [cited December 2020]; Available from: https://www.health.harvard.edu/womens-health/osteopenia-when-you-have-weak-bones-but-not-osteoporosis.

  6. Better Health Channel. Bone density testing. [cited December 2020]; Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/bone-density-testing.

  7. Osteoporosis Australia, What you need to know about Osteoporosis: Medical Guide. 2014.

  8. The Royal Australian College of General Practitioners (RACGP), Clinical guideline for the prevention and treatment of osteoporosis in postmenopausal women and older men. 2010.

  9. Osteoporosis Australia. Diagnosis. 2014 [cited December 2020]; Available from: https://www.osteoporosis.org.au/diagnosis.

  10. Center, J.R., et al., Risk of subsequent fracture after low-trauma fracture in men and women. JAMA, 2007. 297(4): p. 387-94.

  11. Eisman, J., et al., Osteoporosis prevalence and levels of treatment in primary care: the Australian BoneCare Study. J Bone Miner Res, 2004. 19(12): p. 1969-75.

  12. Henry, M.J., et al., Prevalence of osteoporosis in Australian men and women: Geelong Osteoporosis Study. Med J Aust, 2011. 195(6): p. 321-2.

  13. Sanders KM, W.J., Abimanyi-Ochom J, Murtaza G,, Osteoporosis: A Burden of Disease Analysis – Preliminary Data 2016. Osteoporosis Australia,, 2016.

  14. Siris, E.S., et al., Failure to perceive increased risk of fracture in women 55 years and older: the Global Longitudinal Study of Osteoporosis in Women (GLOW). Osteoporos Int, 2011. 22(1): p. 27-35.

  15. Lih, A., et al., Targeted intervention reduces refracture rates in patients with incident non-vertebral osteoporotic fractures: a 4-year prospective controlled study. Osteoporos Int, 2011. 22(3): p. 849-58.

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