Osteoporosis Will Cost Seniors Years of Healthy Aging and Medical Systems Billions. It’s Time to Take a Step Forward.
By Michael Hodin
October 20 is World Osteoporosis Day, a day to recognize that half a billion people will soon be living with osteoporosis, which weakens their bones and increases their risk of fragility fractures, costing global health systems roughly $100 billion per year.[1] Consider this: every 3 seconds, an older adult suffers a fracture, resulting in an estimated 9 million fractures globally every year.[2]
The Global Coalition on Aging (GCOA) Bone Health Initiative (BHI) works to elevate the importance of bone health to the global public health agenda. Bringing together leading experts worldwide to share solutions and raise awareness through the UN Decade of Healthy Ageing.
Bone health is a crucial part of our health
Bone health is critical to an older person’s ability to continue living an active and healthy lifestyle for longer. Individuals who sustain a first fragility fracture are a readily identifiable group at high imminent risk of sustaining second and subsequent fractures. For example, Swedish researchers found that women over 50 who sustained a fragility fracture were far more likely to sustain a second or third fracture within two years. As the world’s population grows older, providing access to quality, timely, integrated bone health care represents a political imperative for leaders worldwide.
The number of people who have osteoporosis will only grow larger as the world grows older. The United Nations predicts that by 2050, the global population aged 60 years and older will double to 2.1 billion, and the number aged 80+ is expected to triple to 426 million.[1] The health and economic cost of fragility fractures are enormous and will grow well beyond $100 billion per year globally before 2050.1, [2], [3], [4] The need to focus on preventing, treating, and rehabilitating fragility fractures is straightforward and ought to be directly on the WHO Decade of Healthy Ageing agenda.
We already have the tools for effective intervention
Imagine a new solution that was proven to address a devastating health condition for millions of people worldwide while saving billions of dollars each year for healthcare systems. We just benefitted from such a scientific discovery — mRNA — that was quickly embraced by policymakers and global public health officials to combat the global pandemic. In the case of osteoporosis, the solution already exists — in the form of fragility fracture prevention strategies. Unfortunately, there has been little coordinated effort to implement these strategies on a global scale.
However, we have witnessed individual progress in countries like Brazil, China, Japan, the U.S., and countries across Europe. For example, Japan, a country with far more old than young across its nation, has understood that bone health is as much a fiscal imperative as it is a health need. The country recently changed its policies to provide access to and reimbursement for fracture liaison services, a powerful tool in better treating the first fracture to mitigate the more costly and deadly second fracture.
The Bone Health Initiative
We cannot let this opportunity to prevent secondary fractures pass; we must act to fund, reimburse, and ensure access to Fracture Liaison Services through a WHO Action Plan under the framework of the Decade of Healthy Ageing to decrease the impact of the second fracture drastically.
The Global Coalition on Aging BHI brings together a partnership of leading scientists, clinicians, policy experts, advocates, and business leaders with expertise across osteoporosis, aging, and public health. Through communications, education, and advocacy to work together on aligning policy change and healthcare practices in line with 21st-century healthy aging realities to ensure the highest quality of life possible for those with or at risk of osteoporosis and, at the same time, reduce the costly impact of osteoporosis and fragility fractures on our health systems.
Our call to action
We have a window of opportunity to improve bone health and reduce the number of secondary fractures globally during the Decade of Healthy Ageing before the world’s number of seniors further accelerates. That is why the BHI is calling for a WHO Action Plan to cover four key areas:
1. Expand post-fracture care services such as Fracture Liaison Services (FLS): FLS is a proven, multi-disciplinary model that works to rehabilitate patients with the first fragility fracture, facilitating the diagnosis of osteoporosis, informing patients, and recommending appropriate treatment.
2. Leverage the four core areas of the Decade of Healthy Ageing: This includes changing how we think, feel, and act towards age and aging; developing communities that foster the abilities of older people; delivering person-centered integrated care and primary health services responsive to older people and inclusive of attention to bone health; and providing older people who need it with access to long-term care.
3. Engage policymakers at every level: This begins with attention to the global health policy agenda. Now is the time to make bone health and osteoporosis a policy priority for the WHO and other Multilateral Organizations, encouraging them to lead by example.
4. Empower primary care providers: Informed and empowered primary care providers are critical in addressing osteoporosis-related fractures, particularly by preventing repeat fractures. We should prioritize early diagnosis and treatment of the underlying osteoporosis, as well as public awareness campaigns and capacity building of PCPs, geriatricians, and other specialized physicians.
Let’s work together
Bone health should rightly join Alzheimer’s, cancer, and cardiovascular disease at the very top of the world’s super-aging healthy aging agenda. The Global Coalition on Aging’s Bone Health Initiative welcomes organizations who want to work together on this critical public health issue and improve the prevention, treatment, and rehabilitation of fragility fractures.
[1] Rashki Kemmak, A., Rezapour, A., Jahangiri, R., Nikjoo, S., Farabi, H., & Soleimanpour, S. (2020). Economic burden of osteoporosis in the world: A systematic review. Medical journal of the Islamic Republic of Iran, 34, 154. https://doi.org/10.34171/mjiri.34.154
[2] U.S. Department of Health and Human Services. (n.d.). Osteoporosis overview. National Institutes of Health. Retrieved June 17, 2022, from https://www.bones.nih.gov/health-info/bone/osteoporosis/overview
[1] UNDESA. (10 Oct 2019). Our World Is Growing Older: UN DESA Releases New Report on Ageing. UN Department of Economic and Social Affairs. https://www.un.org/development/desa/en/news/population/our-world-is-growing-older.html.
[2] International Osteoporosis Foundation. (2022).Burden of Osteoporosis. International Osteoporosis Foundation. accessed on September 14, 2022. https://www.osteoporosis.foundation/policy-makers/burden-osteoporosis
[3] International Osteoporosis Foundation. (27 April 2020). European countries face a costly 23% increase in fragility fractures by 2030. International Osteoporosis Foundation. accessed on September 14, 2022. https://www.osteoporosis.foundation/news/european-countries-face-costly-23-increase-fragility-fractures-2030-20200427-0900
[4] Mo, X., Zhao, S., Wen, Z. et al. (2021) High prevalence of osteoporosis in patients undergoing spine surgery in China. BMC Geriatric 21, 361. https://doi.org/10.1186/s12877-021-02313-8
