Unfortunately, many people think that osteoporosis only happens to little old ladies.
The Garvan Institute's research on osteoporosis dispels this myth.
It is now estimated that osteoporosis costs the Australian healthcare system $7 billion a year, compared to the $2 million in direct costs estimated only a few years ago.
"It's a very common problem," says the Garvan study's lead researcher, Professor John Eisman. "It suffers from this really bad 'image' that it only happens to little old ladies who fall, break their hips and die. But it affects a whole lot more people, men as well as women and younger people, and it has an impact on quality of life as well as survival."
In 1989, Professor Eisman commenced the world's first longitudinal study of measurements in bone density of both men and women. Researchers have now observed the skeletons of two thirds of the people above the age of 60 in the central NSW town of Dubbo for over twenty years.
They were surprised to find that osteoporosis is much more prevalent in men than they thought - one in two older Australian women and almost one in three older Australian men will suffer from osteoporosis or fragility fracture in their later years.
Fractures and mortality
The study has also found a greater number of people with fractures in their 60s and 70s than those in their 80s. Those who suffer any type of fracture are also more likely to die prematurely.
"Previously it was thought that there was only early mortality following hip fractures," says Associate Professor Jackie Center, who works with Professor Eisman on the study. "Some studies had suggested vertebral fractures as well, but we found it with virtually every single fracture."
This limited understanding of the true impact of osteoporosis has meant that most first fractures are treated as those related to major trauma would be, with the risk of further fractures neither investigated nor treated.
"In terms of mortality, women are more likely to die in relation to an osteoporosis fracture than something like breast cancer and men are more likely to die from it than prostate cancer," Eisman says.
Calculating the risk
The Bupa Health Foundation in Australia has supported Eisman and Center in their work to create simple tools to predict an individual's risk of incurring future fractures.
Anyone over 60 can now assess themselves using the Institute's online 'risk calculator' (see below) by entering their age, bone density, and any history of prior falls and/or fractures.
"If people can understand their personal risk, it might help them to make the decision of whether or not they want to do something to reduce their risk of a fracture," says Eisman. "That might be by increasing calcium intake, exercising more, stopping smoking, not drinking to excess or, more effectively, using one of the specific drugs that have a protective effect on the skeleton."
The calculator has already been validated in Europe and Canada. Researchers plan to enable the website to assess individuals' muscle strength and steadiness in order to identify those likely to be particularly badly affected after a fall.