[Epidemiology of osteoporosis]

A representative inquiry (n = 4217) in Zürich revealed that 22% of the female population eats a diet poor in calcium. A connection between calcium-deficient nutrition and other unhealthy lifestyles such as lack of exercise, smoking (> 10 cigarettes/day) and regular alcohol intake (several glasses/day) has been shown by multivariate analysis. Therefore one has to suspect, that every third to fourth woman having several risk factors is at risk at entry in menopause. Primary prevention as a population-oriented strategy is therefore sought by general health-education and prevention of accidents in order to lower risks for fractures. Fractures of the collum femoris alone are on the basis of actual life expectancy in Switzerland responsible for 157,000 hospital days in women and 18,000 in men, corresponding to the annual capacity of an acute-cave hospital with 500 beds. With the aid of a risk-group strategy therefore attempts at secondary prevention are necessary. As a cost-effective screening-test every postmenopausal woman should receive a peripheral quantitative computer-tomography. Women with relatively high bone loss-rates and/or low bone density (insufficient stability) could thus be recognized and offered the benefit of an individualized compliance-promoting protective treatment.