Major osteoporotic fragility fractures: Risk factor updates and societal impact

Abstract

Osteoporosis is a silent disease without any evidence of disease until a fracture occurs. Approximately 200 million people in the world are affected by osteoporosis and 8.9 million fractures occur each year worldwide. Fractures of the hip are a major public health burden, by means of both social cost and health condition of the elderly because these fractures are one of the main causes of morbidity, impairment, decreased quality of life and mortality in women and men. The aim of this review is to analyze the most important factors related to the enormous impact of osteoporotic fractures on population. Among the most common risk factors, low body mass index; history of fragility fracture, environmental risk, early menopause, smoking, lack of vitamin D, endocrine disorders (for example insulin-dependent diabetes mellitus), use of glucocorticoids, excessive alcohol intake, immobility and others represented the main clinical risk factors associated with augmented risk of fragility fracture. The increasing trend of osteoporosis is accompanied by an underutilization of the available preventive strategies and only a small number of patients at high fracture risk are recognized and successively referred for therapy. This report provides analytic evidences to assess the best practices in osteoporosis management and indications for the adoption of a correct healthcare strategy to significantly reduce the osteoporosis burden. Early diagnosis is the key to resize the impact of osteoporosis on healthcare system. In this context, attention must be focused on the identification of high fracture risk among osteoporotic patients. It is necessary to increase national awareness campaigns across countries in order to reduce the osteoporotic fractures incidence.

Epidemiology of hip fractures

“…Drugs, such as glucocorticoids and aromatase inhibitors may also influence bone mass and bone quality or increase fall risk like benzodiazepines [39], antidepressants or anti-psychotics [40]. For more comprehensive lists of risk factors we refer to the literature [41]. Three German studies [42][43][44] support earlier findings [45][46][47] of an increased risk of hip fractures in people with Parkinson's disease, after stroke, or in patients with dementia.…”

Protective Effect of Vanillic Acid on Ovariectomy-Induced Osteoporosis in Rats

“…(Johnell and Kanis, 2006;Liu et al, 2014). Moreover, osteoporosis contributes to enormous socio-economic burden owing to high rates of disability or impairment (high osteoporotic fracture), morbidity and even contributes to death as well (Pisani et al, 2016). Hence, WHO considered osteoporosis as a critical health issue next to cardiovascular disease (Kanis et al, 2013).…”

The management of the patient with osteoporosis: from evidence to clinical practice

“…51 Likewise, the alcohol consumption is considered a risk factor for osteoporosis and pathological fractures. 52 Finally, some interventions on the falls risk were effective to reduce fracture risk: improving the sarcopenic condition through a balanced diet and an appropriate exercise, muscle strengthening programs and restoring balance; administration of tests for falls risk assessment and subsequent prophylactic maneuvers, such as rationalization of comorbidities therapy, mechanical protection intervention and domestic barriers removal; improvement of information on bone-health-related factors and fracture prevention. …”