Senile Osteoporosis as a Geriatric Syndrome

With the rise in the aging population, osteoporosis has become a major health burden. From 50 years of age onward, 4 in 10 women will have a hip, vertebral, or forearm fracture. And in the years to come, they are more likely to die from complications as a consequence of fracture rather than from breast cancer. Although osteoporosis is viewed as a disease occurring in post-menopausal women, men account for 30%of hip fractures worldwide (1). More importantly, osteoporosis causes a greater health burden in older people. Billions of dollars are spent each year in the US on acute and long-term care required for people who sustain osteoporosisrelated fractures (2). Globally, osteoporotic fractures caused an estimated 5.8 million disability adjusted life years in the year 2000 (3). This fi gure is expected to increase worldwide as the population ages. Fractures, as a result of osteoporosis, consume a signifi cant proportion of healthcare resources. Recently, the annual cost of all osteoporotic fractures in the US has been estimated to be $20 billion (2). In 1995, more than 400,000 hospitalizations, 3.4 million outpatient visits, and 179,000 nursing home admissions were a direct consequence of osteoporotic fractures (1). Hip fractures have the highest morbidity and mortality. Almost all of the hip fractures occur after a fall; 80% occur amongst women and 90% occur in people over the age of 50 (2). People with hip fractures have 12–39% higher mortality in the immediate following year compared to the same age population; 13–50% of survivors are not able to walk after the event and 12–20% of the survivors need nursing home placement (2). Vertebral fractures are the most common osteoporotic fractures. Many are not recognized clinically. Whether recognized clinically or not, they cause pain, height loss, deformity, and increased risk for further fractures (4).