Osteoporosis: social and economic impact

The epidemiology of osteoporosis is reviewed, with a discussion of secular changes in incidence, geographical variation, and economic costs. The morbidity and mortality associated with hip, vertebral, and forearm fractures are outlined. The main pathogenetic factors contributing to age-related bone loss and osteoporosis are reviewed. Finally, there is a discussion of the recent advances in fracture risk prediction and the use of independent clinical risk factors to improve bone mineral density-based prediction.