Skip to main content
SpringerLink
Log in

Estimating prevalence of osteoporosis: examples from industrialized countries

  • Original Article
  • Published:
Archives of Osteoporosis Aims and scope Submit manuscript

Abstract

Summary

In nine industrialized countries in North America, Europe, Japan, and Australia, country-specific osteoporosis prevalence (estimated from published data) at the total hip or hip/spine ranged from 9 to 38 % for women and 1 to 8 % for men. In these countries, osteoporosis affects up to 49 million individuals.

Purpose

Standardized country-specific prevalence estimates are scarce, limiting our ability to anticipate the potential global impact of osteoporosis. This study estimated the prevalence of osteoporosis in several industrialized countries (USA, Canada, five European countries, Australia, and Japan) using the World Health Organization (WHO) bone mineral density (BMD)-based definition of osteoporosis: BMD T-score assessed by dual-energy x-ray absorptiometry ≤−2.5.

Methods

Osteoporosis prevalence was estimated for males and females aged 50 years and above using total hip BMD and then either total hip or spine BMD. We compiled published location-specific data, using the National Health and Nutrition Examination Survey (NHANES) III age and BMD reference groups, and adjusted for differences in disease definitions across sources. Relevant NHANES III ratios (e.g., male to female osteoporosis at the total hip) were applied where data were missing for countries outside the USA. Data were extrapolated from geographically similar countries as needed. Population counts for 2010 were used to estimate the number of individuals with osteoporosis in each country.

Results

For females, osteoporosis prevalence ranged from 9 % (UK) to 15 % (France and Germany) based on total hip BMD and from 16 % (USA) to 38 % (Japan) when spine BMD data were included. For males, prevalence ranged from 1 % (UK) to 4 % (Japan) based on total hip BMD and from 3 % (Canada) to 8 % (France, Germany, Italy, and Spain) when spine BMD data were included.

Conclusions

Up to 49 million individuals met the WHO osteoporosis criteria in a number of industrialized countries in North America, Europe, Japan, and Australia.

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

Access this article

Log in via an institution

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. US Department of Health and Human Services (2004) Bone health and osteoporosis: a report of the Surgeon General. U.S. Department of Health and Human Services, Office of the Surgeon General, Rockville, MD

  2. Harvey N, Dennison E, Cooper C (2010) Osteoporosis: impact on health and economics. Nat Rev Rheumatol 6:99–105

    Article  PubMed  Google Scholar 

  3. Cummings SR, Bates D, Black DM (2002) Clinical use of bone densitometry: scientific review. JAMA 288:1889–1897

    Article  PubMed  Google Scholar 

  4. International Osteoporosis Foundation Guidelines incorporating FRAX. Available at http://www.iofbonehealth.org/national-regional-osteoporosis-guidelines. Accessed February 22 2011

  5. Dawson-Hughes B, Looker AC, Tosteson AN, Johansson H, Kanis JA, Melton LJ 3rd (2010) The potential impact of new National Osteoporosis Foundation guidance on treatment patterns. Osteoporos Int 21:41–52

    Article  CAS  PubMed  Google Scholar 

  6. World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO Technical Report Series 843. World Health Organization, Geneva

  7. National Health and Nutrition Examination Survey 1988-1994 (NHANES III). Available at http://www.cdc.gov/nchs/nhanes/nh3data.htm. Accessed September 3 2010

  8. National Health and Nutrition Examination Survey 2005-2008. Available at http://www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm. Accessed April 25 2011

  9. Centers for Disease Control and Prevention (1989) Third National Health and Nutrition Examination Survey (NHANES). Bone densitometry manual. Available at www.cdc.gov/nchs/data/nhanes/nhanes3/cdrom/NCHS/MANUALS/BONE.PDF. Accessed September 14 2010

  10. Centers for Disease Control and Prevention (2009) Dual energy x-ray absorptiometry - femur bone measurements (DXXFEM_D). Available at http://www.cdc.gov/nchs/nhanes/nhanes2005-2006/DXXFEM_D.htm. Accessed June 9 2011

  11. Tenenhouse A, Joseph L, Kreiger N, Poliquin S, Murray TM, Blondeau L, Berger C, Hanley DA, Prior JC (2000) Estimation of the prevalence of low bone density in Canadian women and men using a population-specific DXA reference standard: the Canadian Multicentre Osteoporosis Study (CaMos). Osteoporos Int 11:897–904

    Article  CAS  PubMed  Google Scholar 

  12. Leslie WD, Tsang JF, Lix LM (2008) Effect of total hip bone area on osteoporosis diagnosis and fractures. J Bone Miner Res 23:1468–1476

    Article  PubMed  Google Scholar 

  13. Sanfelix-Genoves J, Reig-Molla B, Sanfelix-Gimeno G, Peiro S, Graells-Ferrer M, Vega-Martinez M, Giner V (2010) The population-based prevalence of osteoporotic vertebral fracture and densitometric osteoporosis in postmenopausal women over 50 in Valencia, Spain (the FRAVO study). Bone 47:610–616

    Article  PubMed  Google Scholar 

  14. del Puente A, Heyse SP, Mandes MG, Mantova D, Carpinelli A, Nutile G, Oriente P (1998) Epidemiology of osteoporosis in women in southern Italy. Aging (Milano) 10:53–58

    Google Scholar 

  15. Kanis JA, Gluer CC (2000) An update on the diagnosis and assessment of osteoporosis with densitometry. Committee of Scientific Advisors, International Osteoporosis Foundation. Osteoporos Int 11:192–202

    Article  CAS  PubMed  Google Scholar 

  16. Naves M, Diaz-Lopez JB, Gomez C, Rodriguez-Rebollar A, Serrano-Arias M, Cannata-Andia JB (2005) Prevalence of osteoporosis in men and determinants of changes in bone mass in a non-selected Spanish population. Osteoporos Int 16:603–609

    Article  CAS  PubMed  Google Scholar 

  17. Holt G, Khaw KT, Reid DM et al (2002) Prevalence of osteoporotic bone mineral density at the hip in Britain differs substantially from the US over 50 years of age: implications for clinical densitometry. Br J Radiol 75:736–742

    Article  CAS  PubMed  Google Scholar 

  18. Yoshimura N, Muraki S, Oka H et al (2009) Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab 27:620–628

    Article  PubMed  Google Scholar 

  19. Ikeda Y, Iki M, Morita A, Aihara H, Kagamimori S, Kagawa Y, Matsuzaki T, Yoneshima H, Marumo F (2002) Age-specific values and cutoff levels for the diagnosis of osteoporosis in quantitative ultrasound measurements at the calcaneus with SAHARA in healthy Japanese women: Japanese population-based osteoporosis (JPOS) study. Calcif Tissue Int 71:1–9

    Article  CAS  PubMed  Google Scholar 

  20. Henry MJ, Pasco JA, Nicholson GC, Seeman E, Kotowicz MA (2000) Prevalence of osteoporosis in Australian women: Geelong Osteoporosis Study. J Clin Densitom 3:261–268

    Article  CAS  PubMed  Google Scholar 

  21. Australian Bureau of Statistics (1996) Census. Catalogue No.2020.0

  22. Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jonsson B, Kanis JA (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

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Kanis JA, Johnell O (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16:229–238

    Article  CAS  PubMed  Google Scholar 

  24. Bultink IE, Baden M, Lems WF (2013) Glucocorticoid-induced osteoporosis: an update on current pharmacotherapy and future directions. Expert Opin Pharmacother 14:185–197

    Article  CAS  PubMed  Google Scholar 

  25. Strom O, Borgstrom F, Kanis JA, Compston J, Cooper C, McCloskey EV, Jonsson B (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

    Article  CAS  PubMed  Google Scholar 

  26. Warriner AH, Saag KG (2013) Osteoporosis diagnosis and medical treatment. Orthop Clin North Am 44:125–135

    Article  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  28. US Department Health and Human Services. Arthitis, osteoporosis and back conditions. In: Healthy people 2010. 2nd ed. Washington: US Government Printing Office; 2000:17-18

  29. Looker AC, Borrud LG, B. D-H, Shepherd JA, Wright NC (2012) Osteoporosis or low bone mass at the femur neck or lumbar spine in older adults: United States, 2005-2008. NCHS data brief no 93. National Center for Health Statistics, Hyattsville, MD

  30. Looker AC, Melton L Jr, Harris TB, Borrud LG, Shepherd JA (2010) Prevalence and trends in low femur bone density among older US adults: NHANES 2005-2006 compared with NHANES III. J Bone Miner Res 25:64–71

    Article  PubMed Central  PubMed  Google Scholar 

  31. ISCD 2007 ISCD Official Positions - adult reference database for T-scores. Available at http://www.iscd.org/official-positions/2007-iscd-official-positions-adult/. Accessed October 20 2010

  32. Faulkner KG, Orwoll E (2002) Implications in the use of T-scores for the diagnosis of osteoporosis in men. J Clin Densitom 5:87–93

    Article  PubMed  Google Scholar 

  33. Wiemann LM, Vallarta-Ast N, Krueger D, Binkley N (2007) Effect of female database use for T-score derivation in men. J Clin Densitom 10:244–248

    Article  PubMed  Google Scholar 

  34. Olszynski WP, Shawn Davison K, Adachi JD et al (2004) Osteoporosis in men: epidemiology, diagnosis, prevention, and treatment. Clin Ther 26:15–28

    Article  PubMed  Google Scholar 

  35. Sone T, Fukunaga M (2004) Prevalence of osteoporosis in Japan and the international comparison. Nihon Rinsho 62(Suppl 2):197–200

    PubMed  Google Scholar 

  36. Iki M, Kagamimori S, Kagawa Y, Matsuzaki T, Yoneshima H, Marumo F (2001) Bone mineral density of the spine, hip and distal forearm in representative samples of the Japanese female population: Japanese Population-Based Osteoporosis (JPOS) Study. Osteoporos Int 12:529–537

    Article  CAS  PubMed  Google Scholar 

  37. Kanis JA, Oden A, Johnell O 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 

Download references

Acknowledgments

Amgen Inc. sponsored this study. Michelle N. Bradley and Mandy Suggitt of Amgen Inc. provided formatting and editing assistance.

Conflicts of interest

SWW: Consultant to Amgen Inc.

CS: Consultant to Amgen Inc.

LAF: Stock ownership in Amgen Inc., and employee of and owns stock/stock options in GlaxoSmithKline

MAS and CDO: Employees of and may own stock/stock options in Amgen Inc.

Author information

Authors and Affiliations

  1. Wade Outcomes Research and Consulting, 358 South 700 East, Suite B-432, Salt Lake City, UT, 84102, USA

    S. W. Wade

  2. Kantar Health, 11960 Westline Industrial Drive, Suite 180, St. Louis, MO, 63146, USA

    C. Strader

  3. GlaxoSmithKline, 2301 Renaissance Blvd, King of Prussia, PA, 19406, USA

    L. A. Fitzpatrick

  4. Amgen Inc., One Amgen Center Drive, MS: 24-2-A, Thousand Oaks, CA, 91320, USA

    M. S. Anthony & C. D. O’Malley

Authors
  1. S. W. Wade
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Strader
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. A. Fitzpatrick
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. S. Anthony
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. C. D. O’Malley
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. S. Anthony.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(DOCX 15.2 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wade, S.W., Strader, C., Fitzpatrick, L.A. et al. Estimating prevalence of osteoporosis: examples from industrialized countries. Arch Osteoporos 9, 182 (2014). https://doi.org/10.1007/s11657-014-0182-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11657-014-0182-3

Keywords

Search

Navigation