Men's Osteoporosis Support Group

Epidemiology of hip fractures in Italy

Osteoporos Int. 2009 Oct 7. Epub 2009 Oct 7. Hip fractures in Italy: 2000-2005 extension study. Piscitelli P. PMID: 19809775. This is an interesting study in regards to the incidence and cost of osteoporosis over a five-year period in the European industrialized country of Italy. The authors concluded, "Hip fractures of the elderly are increasing and represent a major health problem in industrialized countries such as Italy." I won't repeat all the findings, but will highlight some that I found particularly pertinent.

  • 6-year total of people 65 or older with hip fractures: 507,671

  • Percentage of fractures in people 75 years or older: 82.9%

  • Total fracture percentage in older women: 78.2%

  • Total fracture percentage in older men: 4.7%

  • 6-year increase in fracture rate of older patients: 16%

  • 2005 hospitalization cost and 6-year % increase: 467 million euros/36.1%

Editor's comments. What these results highlight is that osteoporosis-caused hip fractures are mainly an issue with individuals older than age 75, and particularly in women. That cost in U.S. currency in 2005 is about 687 million dollars. The population in Italy in 2005 was 58,103,033 people. The 2005 U.S. population was 288.4 million. So if U.S. hip fracture rates parallel those in Italy, we would expect about 4.9 times as many fractures at 4.9 times the cost of treatment. That would equal about 3.3 billion dollars per year to treat U.S. hip fractures.

What is most disturbing is that fracture rates are increasing with double-digit frequency. That in spite of massive treatment and preventive measures by the medical community and organizations like the National Osteoporosis Foundation in the U.S. and similar organizations in other countries. The question is why?

The FRAX concept may be the answer to this question. It is a way to predict the 10-year fracture risk of individuals using multiple parameters. To test yourself, go to the Calculation Tool menu, then select your home country and racial make up, if that is an option. If all individuals older than about 50 years were required to do the FRAX risk assessment at appropriate intervals, those at highest risk of 10-year fracture could then be coaxed to take the strongest preventive measures: routine weight-bearing exercise, adequate intake of vitamin D and calcium, proper diet that emphasizes a metabolic alkaline condition, fall prevention education, and for those at highest risk, FDA-approved osteoporosis medications. Only time will tell if such measures have a detectable impact on hip fracture rates and costs of treatment.

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