Osteoporosis is a skeletal disease that increases bone fragility and susceptibility to fracture. Hip fractures are the most devastating result of osteoporosis; they require the patient to be admitted to hospital and cause serious disability and excess death. In their Seminar Philip Sambrook (Royal North Shore Hospital, Sydney, Australia) and Cyrus Cooper (University of Southampton, UK) write that because worldwide, elderly people represent the fastest growing age-group, the yearly number of fractures is likely to rise substantially with the continued ageing of the population. Even if incidence rates for hip fracture remain stable, the estimated number of hip fractures worldwide will rise from 1.7 million in 1990 to 6.3 million in 2050, state the authors. However, they add that fracture rates seem to be rising in many parts of the world. On the assumption that rates will rise by only 1% per year, the authors calculate that the number of hip fractures worldwide could be as high as 8.2 million by 2050.
The economic burden that osteoporotic fractures impose on health-care systems worldwide is therefore likely to increase. The authors' state: "In 1997, a conservative estimate of the worldwide direct and indirect annual costs of hip fracture was US$131.5 billion. More recently, the combined annual costs of all osteoporotic fractures have been estimated to be $20 billion in the USA and about $30 billion in the European Union."
Contact: Professor Philip N Sambrook, Institute of Bone and Joint Research,Building 36, Royal North Shore Hospital, St Leonards, Sydney 2065, Australia. T) 61 407217415 (mobile) sambrook@med.usyd.edu.au
Journal
The Lancet