Why initially focus on the hip?

Morbidity and mortality are associated with hip fractures1

Osteoporotic fractures are among the most common causes of disability in many regions of the world and many occur as the result of a simple fall. While any fracture negatively impacts the affected individual, hip fractures are the most serious from the public health perspective. Hip fractures require significant system resources such as emergency room visits, hospitalization, surgery, rehabilitation, homecare, etc.

“Hip fractures are by far the most devastating type of fracture, accounting for about 300,000 hospitalizations each year. Almost all hip patients are hospitalized, and they represent nearly half of all hospitalizations for osteoporotic fractures in the United States...”
Report of the Surgeon General (2004)1

Hip fracture prevalence is growing

It is likely that the prevalence of hip fractures will grow in the coming years.

Annual hip fracture incidence rises with age, from 2 fractures per 100,000 among white women < 35 years, to more than 3,000 fractures per 100,000 among white women > 85 years.2

Elderly people are the fastest growing demographic group, so the number of hip fractures per year is expected to rise with the continued aging of the population.2

By 2020, 1 in 2 Americans over age 50 is expected to have or be at risk of developing osteoporosis of the hip.2

Some startling facts:

  • A woman's risk of hip fracture is equal to her combined risk of breast, uterine and ovarian cancer3

  • An average of 24% of patients over age 50 die in the year following their hip fracture3

  • At 6 months, only 15% of hip fracture patients can walk across a room unaided3

  • Hip fracture risk is growing rapidly among Hispanic women4

“The social and economic burden of osteoporotic fractures is increasing worldwide, as the population ages. In the USA, osteoporosis affects more than 10 million individuals, and the yearly expenditure on osteoporotic fractures has exceeded that on breast cancer. The prevention of fractures has therefore become a major public-health priority.”
The Lancet Medical Journal (August 2007)5

References

  1. Bone Health and Osteoporosis: Surgeon General Report http://www.surgeongeneral.gov/library/bonehealth/chapter_5.html chapter 5
  2. Bone Health and Osteoporosis: Surgeon General Report http://www.surgeongeneral.gov/library/bonehealth/chapter_4.html chapter 4
  3. National Osteoporosis Foundation: Fast Facts http://www.nof.org/osteoporosis/diseasefacts.htm
  4. National Osteoporosis Foundation: Bone Tool Kit http://www.nof.org/awareness2/2007/images/Bone_Tool_Kit.pdf page 38
  5. Tang B et al. "Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people 50 years and older: a meta-analysis." The Lancet August 25, 2007;370:657-666