The overall prevalence of osteoporosis in the U.S., using femoral neck and lumbar spine bone mineral density (BMD) data for adults ages 50 and up, is 11.0%, with higher prevalence in women (16.5%) than men (5.1%), researchers said here.
These were some of the findings from a study conducted by the U.S. Bone and Joint Initiative (USBJI) and presented by Nicole Wright, PhD, MPH, of the University of Alabama at Birmingham, at the annual American Society for Bone and Mineral Research meeting.
The USBJI was tasked to report the prevalence as well as economic and healthcare utilization burden of osteoporosis. Wright offered a preview of these findings, as part of the forthcoming 4th edition of the group’s publication, The Burden of Musculoskeletal Diseases.
Said Wright, “We hope that these new estimates of prevalence will continue to increase osteoporosis awareness and prevention…”
A 2017 study of osteoporosis trends examined the prevalence of osteoporosis and low bone mass in U.S. adults over the age of 50 from 2005-2006 through 2013-2014. It used femoral neck or lumbar spine BMD data as collected in the National Health and Nutrition Examination Survey (NHANES). That study put U.S. prevalence of osteoporosis at 11%, nearly a full percentage point higher than estimates made 3 years earlier.
To provide additional insights, the USBJI reviewed data from the 2010-2014 National Inpatient Sample (NIS) and the National Emergency Department Sample (NEDS) for evidence of fragility fractures of the hip, spine, pelvis, femur, wrist, and humerus.
The NIS data set covered about 7 million inpatient hospitalizations each year from all payers, representing about 35 million people nationally. They utilized the the 2013-2014 data for all the adults 50 years or older to identify the fractures that were made on the primary discharge diagnostic code from the ICD-9 and ICD-10 systems.
NIS data was used to evaluate health care utilization, and the Medical Expenditures Panel Survey (MEPS) data to estimate the economic burden of osteoporosis care. NEDS, meanwhile, provided data on an estimated 19.5 million hospitalizations and 46.7 million emergency department visits.
A 2018 study revealed a 20% decline in fractures over the years from 2001 until 2012, after which point the trend plateaued, mostly unchanged until the end of the analysis, in 2015. The USBJI then re-evaluated these hip fracture trends using the available data. From 2010 to 2014, the USBJI observed a 12%-22% decrease in all fracture sites with a 3.5% and 1.4% increase in the number of hip and femur fracture discharges, respectively. The mean length of stay for all fragility fractures was 5.3 (SD 0.87) days, with an average of 6.1 days for femur and just 3.6 days for wrist fractures.
Men, younger individuals, and non-Hispanic blacks had longer lengths of stays than comparator groups. The total direct costs for persons with osteoporosis increased 118% from $28.1 billion in 1998-2000 to $73.6 billion in 2012-2014, with fairly equal distribution between ambulatory care, inpatient, and prescription costs.
Some of the limitations of the data, Wright cautioned, are that the NIS and the NEDS only provide prevalence data and there are no available data that represents incidence. She also noted that 2015 and 2016 NIS data are now available and the USBJI plans to continue updating its estimates.
Wright reported relationships with Amgen and Genentech.
Primary Source
American Society for Bone and Mineral Research
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