Fragility fracture prevention: review from a Japanese perspective

Osteoporosis has been named the silent disease because there are no symptoms until a fragility fracture occurs. With the rapid rise in the elderly population, the number of patients with osteoporosis and fragility fractures has increased in most developed countries. Fragility fractures increase societal burdens in terms of mortality and quality of life, as well as economic costs. Fragility fractures of the hip have the most impact on the ambulatory status of the elderly and its incidence is reported to be lower among Asians or Africans than Caucasians. Increases in the age-specific and gender-specific incidence of hip fracture with time have been reported in Asian countries, including Japan; however, studies in North America, Europe and Oceania have reported decreases in the incidence. A new fragility fracture increases fracture risk, resulting in possible recurrence or other new fractures. The most important strategy for preventing such fractures is a systematic approach to educating and following patients in the immediate postoperative period after the initial fragility fracture.