Sep. 22, 2009 A new audit report issued by the International Osteoporosis Foundation (IOF) shows that osteoporosis is a serious and growing problem throughout Asia.
Gathering data from 14 Asian countries, regions or territories, ‘The Asian Audit’ is a landmark report examining epidemiology, costs and burden in individual countries as well as collectively across the region. The report’s key findings include:
A major increase in fractures is predicted for Asia as a whole
Already hip fracture incidence has risen 2-to 3-fold in most Asian countries over the past 30 years. Furthermore, it is expected that due to expanding populations and increasing longevity, half of the world’s fractures will occur in Asia by 2050.
The prevalence of osteoporosis and fractures is severely underestimated
The belief that osteoporosis is rare in Asia as compared to Western countries has been exposed as a myth. Vertebral fractures are as common in Asians as in Caucasian populations, and as in Western countries, very few of these fractures are diagnosed. Over the past four decades the number of hip fractures increased by 300% in Hong Kong, and by 500% in Singapore. In Japan the number of fractures in people over 75 increased dramatically over the span of 12 years. In mainland China, formerly considered a ‘low risk’ area, almost 70 million people over the age of 50 suffer from osteoporosis, resulting in some 687,000 hip fractures per year.
Vitamin D deficiency and low calcium intake is widespread
Widespread vitamin D deficiency and low calcium intake may be in part responsible for the alarming increase in osteoporosis. Nearly all Asian countries outlined in the report are far below the FAO/WHO recommendations for calcium intake ranging from 1000-1300 mg/day for adults. The average dietary calcium intake for the adult Asian population is approximately 450 mg/day.
Fractures represent a huge personal, social and economic burden
A cost explosion related to the treatment of fractures has been observed in Asia. In China the average length of hospital stay for a hip fracture is greater than that for breast cancer, ovarian cancer, prostate cancer or heart disease. In Hong Kong, China, it is estimated that the acute hospital care cost of hip fracture may amount to 2% of the total hospital budget.
Osteoporosis remains a neglected disease, with great urban-rural disparity
Notwithstanding the burden of fragility fractures, osteoporosis remains greatly under diagnosed and under treated, and both health professional training and public awareness is sub optimal in most countries. With few exceptions, there is a serious lack of solid epidemiological data and research. In addition, DXA technology, considered the gold standard for measurement of bone mineral density, is not widely available or easily accessible in most developing Asian countries. At present most treatments, prevention and education efforts are limited to urban areas, whereas people in rural areas have little knowledge of osteoporosis or access to prevention programs, and diagnostic and treatment facilities. In the most populous countries like China and India, the majority of the population lives in rural areas (60% in China), where hip fractures are often treated conservatively at home instead of surgically in hospitals.
The result: premature death for as many as one in five, immense personal suffering, lost productivity and long-term dependence on family members.
Despite the severity of the problem, osteoporosis is being dangerously ignored as it competes with other diseases for scarce healthcare resources and recognition.
Together with local osteoporosis societies in the region, IOF urges immediate government action to prevent the rising tide of fractures which will have a profound socio-economic impact on millions of people and communities throughout Asia.
The Asian Audit was supported by an unrestricted grant from Fonterra.
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