Prevalence of Osteoporosis in Adults
Osteoporosis affects a significant portion of the adult population, particularly as they age. In the United States, an estimated 10 million people over 50 have osteoporosis. A meta-analysis published in the Journal of Orthopaedic Surgery and Research reported the global prevalence of osteoporosis at 18.3%, with the highest prevalence found in Africa (39.5%). This global figure was found to be 23.1% among women and 11.7% among men. Data from the National Health and Nutrition Examination Survey (NHANES) from 2017–2018 showed that among U.S. adults aged 50 and over, the age-adjusted prevalence was 12.6%.
- Prevalence in the US (2017–2018): Among adults 50 and over, 12.6% had osteoporosis at the femur neck, lumbar spine, or both. This prevalence was significantly higher among women (19.6%) compared to men (4.4%).
- Low Bone Mass (Osteopenia): A precursor to osteoporosis, low bone mass affects an even larger population. In the US, 43.1% of adults aged 50 and over had low bone mass in 2017–2018. Again, this was higher in women (51.5%) than in men (33.5%).
- International Comparisons: A study of industrialized nations found varied prevalence rates in people over 50, such as 26.3% in Japan, 21% in the USA, and lower rates in European countries like Germany (14.3%) and the UK (7.8%).
Fracture Risk and Statistics
Fractures are the most severe consequence of osteoporosis and a major cause of disability and mortality. Worldwide, up to 37 million fragility fractures occur annually in people over 55, translating to about 70 fractures every minute. These fractures can occur from a minor fall or, in severe cases, from simple actions like sneezing.
- Lifetime Risk: The International Osteoporosis Foundation estimates that worldwide, one in three women and one in five men over the age of 50 will experience an osteoporosis-related fracture during their remaining lifetime.
- Hip Fractures: These are among the most serious consequences of osteoporosis, associated with high morbidity and mortality. After a hip fracture, up to 24% of patients aged 50 and over die within one year. Furthermore, only 15% of hip fracture patients can walk across a room unaided six months after the event.
- Underdiagnosis: Despite the high risk, osteoporosis is often underdiagnosed and undertreated. Nearly 80% of older Americans who suffer bone breaks are not tested or treated for osteoporosis.
- Re-fracture Risk: A prior fracture is a significant risk factor for a future one, increasing the risk by 86%. This risk is especially high in the first two years after the initial fracture.
Demographic Impacts and Risk Factors
The statistical data reveals significant differences in osteoporosis prevalence and fracture risk across different demographics. Several modifiable and non-modifiable factors influence a person's risk profile.
- Gender Disparity: Women are at a much higher risk than men, particularly postmenopausal women. The decline in estrogen after menopause accelerates bone loss, contributing to lower bone mass compared to men. IOF estimates that osteoporosis affects roughly two-thirds of women aged 90 and over worldwide.
- Age-Related Increase: Prevalence of osteoporosis rises sharply with age for both sexes. For example, in the US (2017–2018), prevalence for women increased from 13.1% at ages 50–64 to 27.1% at ages 65 and older.
- Race and Ethnicity: In the US, race and ethnicity play a role, although risk exists across all groups. White and Asian women, on average, are at a higher risk than Black women. However, hip fracture incidence among Hispanic women appears to be rising.
- Modifiable Risk Factors: These include lifestyle choices like smoking and heavy alcohol consumption, which both increase risk. Other factors include low body mass index (BMI), low calcium and vitamin D intake, and a sedentary lifestyle.
- Medical Risk Factors: Certain medical conditions, such as inflammatory bowel disease, rheumatoid arthritis, kidney failure, and type 2 diabetes, are linked to a higher risk of osteoporosis. Long-term use of corticosteroids and certain other medications also increases risk.
Economic Burden of Osteoporosis
The medical and societal costs associated with osteoporosis and its related fractures are substantial, and projections indicate they are on the rise.
- US Costs: In the US, osteoporosis is responsible for approximately $19 billion in healthcare costs annually. This is projected to increase significantly, with some estimating annual costs could reach $25.3 billion by 2025.
- Hip Fracture Expenses: The costs associated with hip fractures are particularly high due to hospitalization, surgery, rehabilitation, and long-term care needs. Hip fractures often require extended stays in nursing homes, and many survivors require permanent assistance.
- Comparison with Other Diseases: In women, the incidence of breaking a bone due to osteoporosis is greater than the combined incidence of heart attack, stroke, and breast cancer. This underscores the significant health and economic impact of the condition. In men, the lifetime risk of fragility fracture is greater than that of prostate cancer.
- International Costs: Globally, the economic burden is immense. A systematic review noted that the average direct annual costs of treating osteoporotic fractures can range from $5,000 to $6,500 billion USD in Canada, Europe, and the US alone, not including indirect costs like disability.
Osteoporosis Data Comparison
| Statistic | Women (age 50+) | Men (age 50+) | Source |
|---|---|---|---|
| Prevalence of Osteoporosis (US, 2017-18) | 19.6% | 4.4% | CDC |
| Prevalence of Low Bone Mass (US, 2017-18) | 51.5% | 33.5% | CDC |
| Lifetime Risk of Osteoporotic Fracture (Worldwide) | 1 in 3 | 1 in 5 | IOF |
| Annual Cost (US) | The annual costs are overwhelmingly driven by fractures, which are more common in women. | Annual costs are driven by fractures, though less prevalent than in women. | BHOF |
| Hip Fracture Mortality (1 year) | 20-24% mortality rate is reported, though the rate is higher in men. | Higher 1-year mortality rate than women after a hip fracture. | IOF, MedPage |
The “Care Gap” and Projections
Despite the significant health and economic impacts, osteoporosis remains underdiagnosed and undertreated, a phenomenon sometimes referred to as the “care gap.” Only a small fraction of individuals who suffer an osteoporotic fracture receive proper diagnosis or treatment for the underlying disease. In Europe, the treatment gap for women eligible for therapy was 71% in 2019.
This lack of treatment, combined with aging global populations, means the burden of osteoporosis is set to grow. The International Osteoporosis Foundation projects that the number of hip fractures worldwide could nearly double from 2018 to 2050. Similarly, US-based projections show a substantial increase in both fracture rates and associated costs in the coming years.
Increasing public and professional awareness, improving screening programs, and better adherence to treatment protocols could mitigate this growing public health crisis. The statistics highlight the need for early and effective intervention, especially for at-risk populations like postmenopausal women and the elderly.
Conclusion
The statistical data on osteoporosis reveals a widespread, serious, and costly health problem, particularly affecting older adults and women. With millions suffering from the disease or having low bone density, and millions more at risk of debilitating fractures, the need for increased awareness, effective screening, and accessible treatment is critical. The growing global aging population ensures that the human and economic burden of osteoporosis will continue to rise unless proactive steps are taken to address the care gap. Understanding the prevalence and risk factors from a statistical perspective is the first step toward developing impactful public health strategies for prevention and management.
Learn more about osteoporosis and bone health from the International Osteoporosis Foundation.
