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Osteoporosis is markedly underdiagnosed: a nationwide study from Denmark
Peter Vestergaard1, Lars Rejnmark, Leif Mosekilde
1Department of Endocrinology and Metabolism C, Aarhus University Hospital, Aarhus Amtssygehus, Aarhus, Denmark. p-vest@post4.tele.dk <p-vest@post4.tele.dk>
Summary
Osteoporosis is underdiagnosed and undertreated in Denmark, leading to frequent fractures despite low diagnosis rates. This highlights a critical gap in osteoporosis management and fracture prevention strategies.
Area of Science:
- Public Health
- Epidemiology
- Geriatrics
Background:
- Osteoporosis is a significant public health concern, particularly in aging populations.
- Fracture incidence is a key indicator of the burden of osteoporosis.
- Accurate diagnosis and treatment are crucial for preventing osteoporotic fractures.
Purpose of the Study:
- To compare diagnosed osteoporosis and fracture rates with expected numbers in Denmark.
- To assess the prevalence and incidence of osteoporosis and osteoporotic fractures.
- To evaluate the undertreatment of osteoporosis in Denmark.
Main Methods:
- Utilized the National Hospital Discharge Register for data from 1995-1999.
- Calculated expected osteoporosis prevalence based on Danish bone mineral density (BMD) values.
- Analyzed fracture data and medication use (bisphosphonates, raloxifene, hormone replacement therapy) in individuals aged 50 years and older.
Main Results:
- Estimated osteoporosis prevalence: 40.8% in women and 17.7% in men (aged >=50).
- Observed fracture incidence was significantly lower than expected (8.2% for women, 3.6% for men).
- Low rates of bisphosphonate use (0.3% men, 2.2% women) and high HRT use in women (27.7%) were noted.
Conclusions:
- Osteoporotic fractures are common in Denmark, but osteoporosis diagnosis is infrequent.
- Osteoporosis appears to be significantly underdiagnosed and undertreated.
- Underdiagnosis and undertreatment have major implications for fracture prevention efforts.