Across the world
Osteoporosis is a major non-communicable disease and the most common bone disease, affecting one in three women and one in five men over the age of 50 worldwide Kanis, J.A., et al., Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int, 2000. 11(8): p. 669-74.
Melton, L.J., 3rd, et al., Bone density and fracture risk in men. J Bone Miner Res, 1998. 13(12): p. 1915-23.
Melton, L.J., 3rd, et al., Perspective. How many women have osteoporosis? J Bone Miner Res, 1992. 7(9): p. 1005-10.
. The clinical consequence of osteoporosis is fragility fractures Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med, 1993. 94(6): p. 646-50.
. It has been shown that an initial fracture is a major risk factor for a new fracture Kanis, J.A., et al., A meta-analysis of previous fracture and subsequent fracture risk. Bone, 2004. 35(2): p. 375-82.
. With the rapid ageing of the population worldwide and the changes in lifestyle habits, the incidence of osteoporosis and related fractures has significantly increased and will continue to increase markedly in the future. Due to its prevalence worldwide, osteoporosis is considered a serious public health concern Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med, 1993. 94(6): p. 646-50.
Genant, H.K., et al., Interim report and recommendations of the World Health Organization Task-Force for Osteoporosis. Osteoporos Int, 1999. 10(4): p. 259-64.
- Information on epidemiology of fragility fractures
- Epidemiological data can also be found in our facts & statistics
It is estimated that 75 million people in Europe, USA and Japan are affected by osteoporosis Kanis, J. Assessment of osteoporosis at the primary health-care level. WHO Scientific Group Technical Report. 2007 [Accessed 22.02.2019];
See link. In Asia, osteoporosis is greatly under-diagnosed and under-treated, even in the most high-risk patients who have already fractured. The problem is particularly acute in rural areas. In the most populous countries like China and India, the majority of the population lives in rural areas (60% in China), where hip fractures are often treated conservatively at home instead of by surgical treatment in hospitals International Osteoporosis Foundation: The Asian Audit - Epidemiology, costs and burden of osteoporosis in Asia 2009. 2009;
Worldwide, osteoporosis is estimated to affect 200 million women - approximately one-tenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and two-thirds of women aged 90 Kanis, J. Assessment of osteoporosis at the primary health-care level. WHO Scientific Group Technical Report. 2007 [Accessed 22.02.2019];
See link. An IOF survey, conducted in 11 countries, showed denial of personal risk by postmenopausal women, lack of dialogue about osteoporosis with their doctor, and restricted access to diagnosis and treatment before the first fracture result in under-diagnosis and undertreatment of the disease International Osteoporosis Foundation: How fragile is her future? 2000;
See link. Furthermore, the ageing of populations across the globe will be responsible for a major increase in the incidence of osteoporosis in postmenopausal women Reginster, J.Y. and N. Burlet, Osteoporosis: a still increasing prevalence. Bone, 2006. 38(2 Suppl 1): p. S4-9.
Some regional data
Based on WHO diagnostic criteria (T-score less than or equal to -2.5 SD) approximately 22 million women and 5.5 million men aged between 50-84 years of age are estimated to have osteoporosis in the EU (2010 figures). Due to changes in population demography the number of men and women with osteoporosis in the EU will rise from 27.5 million in 2010 to 33.9 million in 2025, corresponding to an increase of 23% Hernlund, E., et al., Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos, 2013. 8: p. 136.
Canada: In 2000, osteoporosis affected approximately 1.4 million Canadians, mainly postmenopausal women and the elderly. Over the age of 50, this included 1 in 4 women and 1 in 8 men Report of the Strategic Action Working Group on Osteoporosis for the Ontario Women's Health Council: A Framework and Strategy for the Prevention and Management of Osteoporosis. 2000 [Accessed 26.02.2019];
See linkOsteoporosis: Preventing A Fractured Future, A Summary Policy Statement by the Osteoporosis Society of Canada. 2004;
See link. After a Canadian Community Health Survey in 2009 by the Public Health Agency of Canada, it was revealed that in Canadians of 40 years or older, 1.5 million (10%) reported having been diagnosed with osteoporosis Public Health Agency of Canada: What is the impact of osteoporosis in Canada and what are Canadians doing to maintain healthy bones? 2009 [Accessed 20.02.2019];
See link. In 2017, the number of Canadians affected by osteoporosis had increased to 2 million Osteoporosis Canada: Impact Report 2017. 2017 [Accessed 26.02.2019];
USA: Osteoporosis and low bone mass are currently estimated to be a major public health threat for almost 54 million U.S. women and men aged 50 and older Wright, N.C., et al., The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res, 2014. 29(11): p. 2520-6
. The key findings from this study highlight two risk factors for osteoporosis: gender and age. Among the 10.2 million adults estimated to have osteoporosis in the United States, more than 80% were women. Further, a clear correlation exists between the prevalence of osteoporosis and increasing age.
The prevalence of vertebral osteopenia in women 50 years and older has been reported at 45.5-49.7% and vertebral osteoporosis at 12.1-17.6%; while the prevalence of femoral neck osteopenia has been reported at 46-57.2% and femoral neck osteoporosis at 7.9-22% Morales-Torres, J. and S. Gutierrez-Urena, The burden of osteoporosis in Latin America. Osteoporos Int, 2004. 15(8): p. 625-32.
Prevalence of low bone mass is higher in the Middle East than in western countries Maalouf, G., et al., Middle East and North Africa consensus on osteoporosis. J Musculoskelet Neuronal Interact, 2007. 7(2): p. 131-43.
. Despite ample sunshine, the Middle East and Africa register the highest rates of rickets worldwide. Hypovitaminosis D is highly prevalent in the Middle Eastern and African region and could be a contributing factor to osteoporosis Sweileh, W.M., et al., Osteoporosis is a neglected health priority in Arab World: a comparative bibliometric analysis. Springerplus, 2014. 3: p. 427
International Osteoporosis Foundation: The Middle East & Africa Regional Audit - Epidemiology, costs & burden of osteoporosis in 2011. 2011;
China: The overall prevalence of osteoporosis in mainland China might be approximately 7% among adults, 10-20% in urban areas, 22.5% among men aged 50 years or more, and 50.1% among women aged 50 years or more Wang, Y., et al., Osteoporosis in China. Osteoporos Int, 2009. 20(10): p. 1651-62
India: In a study among Indian women aged 30-60 years from low income groups, BMD at all the skeletal sites were much lower than values reported from developed countries, with a high prevalence of osteopenia (52%) and osteoporosis (29%) thought to be due to inadequate nutrition Shatrugna, V., et al., Bone status of Indian women from a low-income group and its relationship to the nutritional status. Osteoporos Int, 2005. 16(12): p. 1827-35.
Japan: The prevalence of osteoporosis in the Japanese female population aged 50-79 years has been estimated to be about 35% at the spine and 9.5% at the hip Iki, M., et al., Bone mineral density of the spine, hip and distal forearm in representative samples of the Japanese female population: Japanese Population-Based Osteoporosis (JPOS) Study. Osteoporos Int, 2001. 12(7): p. 529-37.
Pakistan: Osteoporosis seems to be a significant problem due to major nutritional issues as well as limited and under-utilised diagnostic facilities International Osteoporosis Foundation: The Asia-Pacific Regional Audit - Epidemiology, costs and burden of osteoporosis in 2013. 2013;
Australia: In 2001, it was estimated that nearly 2 million Australians had osteoporotic conditions Access Economics Pty Limited, Canberra ACT for Osteoporosis Australia: The Burden of Brittle Bones: Costing Osteoporosis in Australia. 2001;
See link. In 2012, in the age group of 50 years or older, 66% of these individuals have osteoporosis or osteopenia, which represents an increase to 4.7 million Australians International Osteoporosis Foundation: The Asia-Pacific Regional Audit - Epidemiology, costs and burden of osteoporosis in 2013. 2013;
See linkOsteoporosis Australia: Osteoporosis costing all Australians - A new burden of disease analysis - 2012 to 2022. 2012 [Accessed 22.02.2019];
New Zealand: A report in the year 2007 estimated that almost 70,000 people over 50 years were diagnosed with osteoporosis, almost 90% of them being female. It is estimated that the actual prevalence of osteoporosis may be higher than reported due to several factors such as the high cost of dual-energy X-ray absorptiometry (DXA), low reimbursement, under-reporting of vertebral fractures and under-documentation of osteoporosis cases International Osteoporosis Foundation: The Asia-Pacific Regional Audit - Epidemiology, costs and burden of osteoporosis in 2013. 2013;
See linkBrown, P., McNeill, R, Radwan, E & Willingale, J The Burden of Osteoporosis in New Zealand 2007-2020 for Osteoporosis New Zealand Inc. 2007;
Comparison with other chronic diseases
Surprisingly, osteoporosis is much more common than other diseases which usually catch public attention, even though the consequences of certain fractures can lead to death. A one-in-nine risk of developing breast cancer has been observed in white women, which is lower than the one-in-six lifetime risk of hip fracture in this population van Staa, T.P., et al., Epidemiology of fractures in England and Wales. Bone, 2001. 29(6): p. 517-22
. In women over 45 years of age, osteoporosis accounts for more days in hospital than may other diseases, including diabetes, myocardial infarction and breast cancer O'Neill, T.W., et al., The prevalence of vertebral deformity in european men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res, 1996. 11(7): p. 1010-8.
Additionally, osteoporosis takes a huge personal and economic toll. The ensuing fragility fractures have major impacts on the quality of life by causing substantial pain, disability, loss of independence, morbidity and even mortality for the affected patients. In Europe, the disability due to osteoporosis is greater than that caused by cancers (with the exception of lung cancer) and is comparable or greater than that lost to a variety of chronic noncommunicable diseases, such as rheumatoid arthritis, asthma and high blood pressure related heart disease Johnell, O. and J.A. Kanis, An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int, 2006. 17(12): p. 1726-33.