Skip to main content
Log in

Burden of high fracture probability worldwide: secular increases 2010–2040

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

The number of individuals aged 50 years or more at high risk of osteoporotic fracture worldwide in 2010 was estimated at 158 million and is set to double by 2040.

Introduction

The aim of this study was to quantify the number of individuals worldwide aged 50 years or more at high risk of osteoporotic fracture in 2010 and 2040.

Methods

A threshold of high fracture probability was set at the age-specific 10-year probability of a major fracture (clinical vertebral, forearm, humeral or hip fracture) which was equivalent to that of a woman with a BMI of 24 kg/m2 and a prior fragility fracture but no other clinical risk factors. The prevalence of high risk was determined worldwide and by continent using all available country-specific FRAX models and applied the population demography for each country.

Results

Twenty-one million men and 137 million women had a fracture probability at or above the threshold in the world for the year 2010. The greatest number of men and women at high risk were from Asia (55 %). Worldwide, the number of high-risk individuals is expected to double over the next 40 years.

Conclusion

We conclude that individuals with high probability of osteoporotic fractures comprise a very significant disease burden to society, particularly in Asia, and that this burden is set to increase markedly in the future. These analyses provide a platform for the evaluation of risk assessment and intervention strategies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Vos T, Flaxman AD, Naghavi M et al (2012) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study. 2010. Lancet 380(9859):2163–2196

    Article  PubMed  Google Scholar 

  2. Murray CJ, Vos T, Lozano R et al (2012) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380(9859):2197–2223

    Article  PubMed  Google Scholar 

  3. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H et al (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2224–2260

    Article  PubMed Central  PubMed  Google Scholar 

  4. Cooper C, Campion G, Melton LJ III (1992) Hip fractures in the elderly: a world-wide projection. Osteoporos Int 2:285–289

    Article  CAS  PubMed  Google Scholar 

  5. Gullberg B, Johnell O, Kanis JA (1997) World-wide projections for hip fracture. Osteoporos Int 7:407–413

    Article  CAS  PubMed  Google Scholar 

  6. Johnell O, Kanis JA (2004) An estimate of the world-wide prevalence, disability and mortality associated with hip fracture. Osteoporos Int 15:897–902

    Article  CAS  PubMed  Google Scholar 

  7. Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733

    Article  CAS  PubMed  Google Scholar 

  8. Odén A, McCloskey EV, Johansson H, Kanis JA (2013) Assessing the impact of osteoporosis on the burden of hip fractures. Calcif Tissue Int 92:42–49

    Article  PubMed  Google Scholar 

  9. Kanis JA, Oden A, Johnell O, Johansson H, De Laet C, Brown J et al (2007) The use of clinical risk factors enhances the performance of BMD in the prediction of hip and osteoporotic fractures in men and women. Osteoporos Int 18:1033–1046

    Article  CAS  PubMed  Google Scholar 

  10. Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141

    Article  CAS  PubMed  Google Scholar 

  11. Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ 3rd, Khaltaev N (2008) A reference standard for the description of osteoporosis. Bone 42:467–475

    Article  CAS  PubMed  Google Scholar 

  12. Johansson H, Kanis JA, Oden A, Compston J, McCloskey E (2012) A comparison of case-finding strategies in the UK for the management of hip fractures. Osteoporos Int 23:907–915

    Article  CAS  PubMed  Google Scholar 

  13. Committee for Medicinal Products for Human Use (CHMP) (2006) Guideline on the evaluation of medicinal products in the treatment of primary osteoporosis. Ref CPMP/EWP/552/95Rev.2. London, CHMP. Nov 2006

  14. Kanis JA, Hans D, Cooper C, and the Task Force of the FRAX Initiative et al (2011) Interpretation and use of FRAX in clinical practice. Osteoporos Int 22:395–411

    Google Scholar 

  15. Kanis JA, Borgström F, Compston J, Dreinhöfer K, Nolte E, Jonsson L, Lems WF, McCloskey EV, Rizzoli R, Stenmark J (2013) SCOPE: a scorecard for osteoporosis in Europe. Arch Osteoporos 8:144. doi:10.1007/s11657-013-0144-1

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  16. Kanis JA, Johansson H, Oden A, Cooper C, McCloskey EV, and the Epidemiology and Quality of Life Working Group of IOF (2013) Worldwide uptake of FRAX. Arch Osteoporos 8:166. doi:10.1007/s11657-013-0166-8

    Article  Google Scholar 

  17. Compston J, Cooper A, Cooper C, on behalf of the National Osteoporosis Guideline Group (NOGG) et al (2009) Guidelines for the diagnosis and management of osteoporosis in postmenopausal women and men from the age of 50 years in the UK. Maturitas 62:105–108

    Article  CAS  PubMed  Google Scholar 

  18. Lekawasam S, Adachi JD, Agnusdei D, Bilezikian J, Boonen S, Borgström F, for the Joint IOF-ECTS GIO Guidelines Working Group et al (2012) A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis. Osteoporos Int 23:2257–2276

    Article  Google Scholar 

  19. Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster J-Y, on behalf of the Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the Committee of Scientific Advisors of the International Osteoporosis Foundation ( IOF) (2013) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 24:23–57

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Briot K, Cortet B, Thomas T et al (2012) 2012 update of French guidelines for the pharmacological treatment of postmenopausal osteoporosis. Bone Joint Spine 79:304–313

    Article  Google Scholar 

  21. Grigorie D, Sucaliuc A, Johansson H, Kanis JA, McCloskey E (2013) The application of FRAX® to determine intervention thresholds for osteoporosis in Romania. Arch Osteoporos 8:164

    Article  PubMed  Google Scholar 

  22. Johansson H, Kanis JA, McCloskey EV, Odén A, Devogelaer J-P, Kaufman J-M, Neuprez A, Hiliigsmann M, Bruyere O, Reginster JY (2010) A FRAX® model for the assessment of fracture probability in Belgium. Osteoporos Int 22:453–461

    Article  PubMed  Google Scholar 

  23. Kanis JA (2013) Commentary on guidelines on postmenopausal osteoporosis—Indian Menopause Society. J Midlife Health 4:129–131

  24. Lekamwasam S (2013) Sri Lankan FRAX model and country specific intervention thresholds. Arch Osteoporos 8(1-2):148. doi:10.1007/s11657-013-0148-x

    Article  PubMed  Google Scholar 

  25. Lippuner K, Johansson H, Kanis JA, Rizzoli R (2010) FRAX® assessment of osteoporotic fracture probability in Switzerland. Osteoporos Int 21:381–390

    Article  CAS  PubMed  Google Scholar 

  26. McGowan B, Kanis JA, Johansson H, Silke C, Whelan B (2013) Development and use of FRAX in the management of osteoporosis in Ireland. Arch Osteoporos 8(1-2):146. doi:10.1007/s11657-013-0146-z

    Article  CAS  PubMed  Google Scholar 

  27. Russian Association on Osteoporosis (2013) http://www.osteoporoz.ru/content/view/891/113/

  28. Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J et al (2013) 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 8:136. doi:10.1007/s11657-013-0136-1

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  29. Strom O, Borgström F, Kanis JA, Compston JE, Cooper C, McCloskey E et al (2011) Osteoporosis: burden, health care provision and opportunities in the EU. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 6:59–155. doi:10.1007/s11657-011-0060-1

    Article  CAS  PubMed  Google Scholar 

  30. Lippuner K, Johansson H, Borgström F, Kanis JA, Rizzoli R (2012) Cost-effective intervention thresholds against osteoporotic fractures based on FRAX® in Switzerland. Osteoporos Int 23:2579–2589

    Article  CAS  PubMed  Google Scholar 

  31. Kanis JA, Brazier JE, Stevenson M, Calvert NW, Lloyd Jones M (2002) Treatment of established osteoporosis: a systematic review and cost-utility analysis. Health Technol Assess 6(29):1–255

    Article  CAS  PubMed  Google Scholar 

  32. Kanis JA, Odén A, McCloskey EV, Johansson H, Wahl D, Cyrus Cooper C, on behalf of the IOF Working Group on Epidemiology and Quality of Life (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23:2239–2256

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  33. United Nations (2010) World Population prospects, the 2010 revision. Department of Economic and Social Affairs, UN (http://esa.un.org/unpd/wpp/unpp/panel_indicators.htm) Accessed Feb 2014

  34. Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A (2001) The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int 12:417–427

    Article  CAS  PubMed  Google Scholar 

  35. Johansson H, Kanis JA, Oden A, Compston J, McCloskey E (2012) A comparison of case-finding strategies in the UK for the management of hip fractures. Osteoporos Int 23:907–915

    Article  CAS  PubMed  Google Scholar 

  36. Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761–1767

    Article  PubMed  Google Scholar 

  37. Felsenberg D, Silman AJ, Lunt M et al (2002) Incidence of vertebral fracture in Europe: results from the European Prospective Osteoporosis Study Epos. J Bone Min Res 17:716–724

    Article  CAS  Google Scholar 

  38. Johnell O, Gullberg B, Kanis JA (1977) The hospital burden of vertebral fracture in Europe: a study of national register sources. Osteoporos Int 7:138–144

    Article  Google Scholar 

  39. Johnell O, Kanis JA (2005) Epidemiology of osteoporotic fractures. Osteoporos Int 16(suppl 2):S3–S7

    Article  PubMed  Google Scholar 

  40. Siggeirsdottir K, Aspelund T, Johansson H, Gudmundsson EF, Mogensen B, Jonsson BY et al (2014) The incidence of a first major osteoporotic fracture in Iceland and implications for FRAX. Osteoporos Int 25:2445–2451

    Article  CAS  PubMed  Google Scholar 

  41. Lam A, Leslie WD, Lix LM, Yogendran M, Morin SN, Majumdar SR (2014) Major osteoporotic to hip fracture ratios in Canadian men and women with Swedish comparisons: a population-based analysis. J Bone Miner Res 29:1067–1073

    Article  PubMed  Google Scholar 

  42. Kanis JA, Johansson H, Odén A, McCloskey EV (2012) The distribution of FRAX® based probabilities in women from Japan. J Bone Miner Metab 30:700–705

    Article  PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. A. Kanis.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Odén, A., McCloskey, E.V., Kanis, J.A. et al. Burden of high fracture probability worldwide: secular increases 2010–2040. Osteoporos Int 26, 2243–2248 (2015). https://doi.org/10.1007/s00198-015-3154-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-015-3154-6

Keywords

Navigation