Epidemiology

Epidemiology

The findings of the most recent epidemiological studies on fragility fractures are summarised below. Hip fractures are, arguably, the most catastrophic fragility fracture for sufferers and their families, and the most costly to healthcare systems. However, they only represent around 20% of the total incidence of all fragility fractures. Sixty percent of the global burden attributable to osteoporosis relates to fractures at sites other than the hip. As such, all fragility fractures should be considered clinically important and financially significant.

Hip fractures

In year 2000, 1.6 million hip fractures occurred worldwide.

More recent data on hip fracture incidence is available from a growing number of countries throughout the world:

Europe
A comprehensive report on the epidemiology, burden and treatment of osteoporosis in the EU27 countries was published in 2013. This report estimated that 610,000 hip fractures occurred in the EU27 in 2010. A compendium of country-specific reports provided estimates for the individual countries. See:

Osteoporosis in the European Union: medical management, epidemiology and economic  burden. Arch Osteoporos. 2013;8(1-2):136. PubMed ID 24113837

Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos. 2013;8(1-2):137. PubMed ID 24113838

Asia-Pacific
Epidemiological data on hip fractures in this region is sparse. However, annual incidence data from the more populous countries gives an indication of the enormous burden of disease:

  • China: Almost 700,000 hip fractures occurred in 2008
  • India: More than 440,000 hip fractures were estimated to have occurred in 2008
  • Japan: More than 148,000 hip fractures were estimated to have occurred in 2007

In 2013, the International Osteoporosis Foundation (IOF) published a second regional audit for Asia, which included Australia and New Zealand. This audit summarised all available information on the epidemiology of fragility fractures in this region:

The Asia-Pacific Regional Audit: Epidemiology, costs & burden of osteoporosis in 2013. Mithal A, Ebeling P, Kyer CS. International Osteoporosis Foundation. 2013. Link.

Middle-East
Epidemiological data on hip fractures in this region is sparse. However, annual incidence data from the more populous countries gives an indication of the burden of disease:

  • Iran: 50,000 hip fractures occurred in 2010
  • Saudi Arabia: More than 8,700 hip fractures occurred in 2004
  • Turkey: Approximately 24,000 hip fractures occurred in 2009

In 2011, the International Osteoporosis Foundation (IOF) published a regional audit for the Middle East and Africa. This audit summarised all available information on the epidemiology of fragility fractures in this region:

The Middle East & Africa Regional Audit: Epidemiology, costs & burden of osteoporosis in 2011. El-Hajj Fuleihan G, Adib G, Nauroy L. International Osteoporosis Foundation. 2011. Link.

Africa
Epidemiological data on hip fractures in this region is sparse. Hip fracture rates for countries that have data available are amongst the lowest in the world. Estimates of annual incidence are available for Morocco and Tunisia:

  • Morocco: More than 4,300 hip fractures were estimated to have occurred in 2010
  • Tunisia: More than 3,100 hip fractures occurred in 2001

In 2011, the International Osteoporosis Foundation (IOF) published a regional audit for the Middle East and Africa. This audit summarised all available information on the epidemiology of fragility fractures in Kenya, Morocco, South Africa and Tunisia:

The Middle East & Africa Regional Audit: Epidemiology, costs & burden of osteoporosis in 2011. El-Hajj Fuleihan G, Adib G, Nauroy L. International Osteoporosis Foundation. 2011. Link.

North America
The epidemiology of hip fracture has been evaluated in Canada and the United States:

  • Canada: Almost 29,000 hip fractures occurred in 2007-8
  • United States: Almost 300,000 hip fractures occurred in 2005

See:

The burden of illness of osteoporosis in Canada. Osteoporos Int. 2012 Nov;23(11):2591-2600. PubMed ID 22398854

Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007 Mar;22(3):465-475. PubMed ID 17144789

Latin America
Epidemiological data on hip fractures in this region is sparse. However, annual incidence data from the more populous countries gives an indication of the burden of disease:

  • Argentina: More than 34,000 hip fractures were estimated to have occurred in 2010
  • Brazil: 121,000 hip fractures were estimated to have occurred in 2012
  • Mexico: Almost 16,000 hip fractures were estimated to have occurred in 2010

In 2012, the International Osteoporosis Foundation (IOF) published a regional audit for Latin America. This audit summarised all available information on the epidemiology of fragility fractures in this region:

The Latin America Regional Audit: Epidemiology, costs & burden of osteoporosis in 2012. Zanchetta J et al. International Osteoporosis Foundation. 2012. Link.

Non-hip non-vertebral fractures

In year 2000, 5.9 million non-hip non-vertebral fractures occurred worldwide.

More recent data on non-hip non-vertebral fracture incidence is available from a number of countries throughout the world. As compared to hip and vertebral fractures, there is a comparative paucity of data on these types of fracture:

Europe
A comprehensive report on the epidemiology, burden and treatment of osteoporosis in the EU27 countries was published in 2013. This report estimated that 2.36 million non-hip non-vertebral fractures occurred in the EU27 in 2010, including 560,000 forearm fractures. A compendium of country-specific reports provided estimates for the individual countries. See:

Osteoporosis in the European Union: medical management, epidemiology and economic burden. Arch Osteoporos. 2013;8(1-2):136. PubMed ID 24113837

Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos. 2013;8(1-2):137. PubMed ID 24113838

Asia-Pacific
Epidemiological data on non-hip non-vertebral fractures in this region is sparse. A study which evaluated a nationwide sample of women and men aged 50 years and over from five major cities in China reported the prevalence of fracture to be 26.6%. Whilst this sample includes patients with hip and vertebral fractures, this does give an indication of the prevalence of non-vertebral non-hip fractures in China. Osteoporosis Australia’s new burden of disease analysis reported that more than 92,000 non-hip non-vertebral fractures occurred in Australia in 2012.
Middle East
Epidemiological data on non-hip non-vertebral fractures in this region is very limited.
Africa
Epidemiological data on non-hip non-vertebral fractures in this region is very limited.
North America
The epidemiology of non-hip non-vertebral fracture has been evaluated in Canada and the United States:

  • Canada: More than 20,000 non-hip non-vertebral fractures resulting in hospitalisation occurred in 2007-8
  • United States: More than 1.2 million non-hip non-vertebral fractures occurred in 2005

See:

The burden of illness of osteoporosis in Canada. Osteoporos Int. 2012 Nov;23(11):2591-2600. PubMed ID 22398854

Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007 Mar;22(3):465-475. PubMed ID 17144789

Latin America
Epidemiological data on non-hip non-vertebral fractures in this region is sparse. The Brazilian Osteoporosis Study (BRAZOS) identified the prevalence of fragility fractures at all skeletal sites in a representative sample of Brazilian women and men aged 40 years and older. Fragility fractures were present in 15.1% of women and 12.8% of men, with notable variation in prevalence between geographic regions of Brazil. The fractures reported were mainly at sites other than hip and spine, which accounted for just 12% and 4% of fractures, respectively. In Mexico, more than 34,000 forearm fractures and 11,000 humerus fractures occurred in 2010.

Vertebral fracture

In 2000, 1.4 million clinical vertebral fractures occurred worldwide.

More recent data on non-hip non-vertebral fracture incidence is available from a number of countries throughout the world. As compared to hip and vertebral fractures, there is a comparative paucity of data on these types of fracture:

Europe
A comprehensive report on the epidemiology, burden and treatment of osteoporosis in the EU27 countries was published in 2013. This report estimated that 520,000 clinical vertebral fractures occurred in the EU27 in 2010. A compendium of country-specific reports provided estimates for the individual countries. See:

Osteoporosis in the European Union: medical management, epidemiology and economic burden. Arch Osteoporos. 2013;8(1-2):136. PubMed ID 24113837

Osteoporosis in the European Union: a compendium of country-specific reports. Arch Osteoporos. 2013;8(1-2):137. PubMed ID 24113838

Asia-Pacific
Epidemiological data on vertebral fractures in this region is limited. Estimates suggest that 1.8 million vertebral fractures caused by osteoporosis occurred in Mainland China in 2006. Osteoporosis Australia’s new burden of disease analysis reported that more than 25,500 vertebral fractures occurred in Australia in 2012.

In 2013, the International Osteoporosis Foundation (IOF) published a second regional audit for Asia, which included Australia and New Zealand. This audit summarised all available information on the epidemiology of fragility fractures in this region:

The Asia-Pacific Regional Audit: Epidemiology, costs & burden of osteoporosis in 2013. Mithal A, Ebeling P, Kyer CS. International Osteoporosis Foundation. 2013. Link.

Middle East
Epidemiological data on vertebral fractures in this region is very limited.

In 2011, the International Osteoporosis Foundation (IOF) published a regional audit for the Middle East and Africa. This audit summarised all available information on the epidemiology of fragility fractures in this region:

The Middle East & Africa Regional Audit: Epidemiology, costs & burden of osteoporosis in 2011. El-Hajj Fuleihan G, Adib G, Nauroy L. International Osteoporosis Foundation. 2011. Link.

Africa
Epidemiological data on vertebral fractures in this region is very limited.

In 2011, the International Osteoporosis Foundation (IOF) published a regional audit for the Middle East and Africa. This audit summarised all available information on the epidemiology of fragility fractures in Kenya, Morocco, South Africa and Tunisia:

The Middle East & Africa Regional Audit: Epidemiology, costs & burden of osteoporosis in 2011. El-Hajj Fuleihan G, Adib G, Nauroy L. International Osteoporosis Foundation. 2011. Link.

North America
The epidemiology of vertebral fracture has been evaluated in Canada and the United States:

  • Canada: Almost 2,300 vertebral fractures resulting in hospitalisation occurred in 2007-8
  • United States: More than 547,000 million vertebral fractures occurred in 2005

See:

The burden of illness of osteoporosis in Canada. Osteoporos Int. 2012 Nov;23(11):2591-2600. PubMed ID 22398854

Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007 Mar;22(3):465-475. PubMed ID 17144789

Latin America
The Latin American Vertebral Osteoporosis Study (LAVOS) reported on the prevalence of radiographic vertebral fractures in women aged 50 years and older in Argentina, Brazil, Colombia, Mexico, and Puerto Rico. Overall, the prevalence of radiographic vertebral fracture was 11.2%, ranging from 12% in Puerto Rico to more than 19% in Mexico. More recent data from Mexico suggests that more than 14,700 clinical vertebral fractures occurred in women and men aged over 40 years in 2010.