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Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
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The global burden attributable to low bone mineral density.

L Sànchez-Riera1, E Carnahan2, T Vos2

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Low bone mineral density (BMD) significantly contributes to global health burdens from fractures and falls, with associated deaths and disability-adjusted life years (DALYs) nearly doubling between 1990 and 2010.

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Area of Science:

  • Epidemiology
  • Public Health
  • Gerontology

Background:

  • The Global Burden of Disease Study 2010 analyzed 291 diseases and 67 risk factors using DALYs.
  • Osteoporosis was not classified as a disease; bone mineral density (BMD) was assessed as a risk factor for fractures and falls.

Purpose of the Study:

  • To determine the global distribution of BMD.
  • To calculate the population attributable fraction (PAF) of BMD for fractures, falls, and DALYs.

Main Methods:

  • A systematic review identified population-based studies measuring femoral neck BMD via dual-energy X-ray absorptiometry in individuals aged 50+.
  • Comparative risk assessment methodology was employed to compute PAFs for BMD-related fractures.
  • NHANES III data provided the theoretical minimum risk exposure distribution; meta-analysis data supplied relative fracture risks.

Main Results:

  • Global deaths and DALYs linked to low BMD rose from 103,000 and 3,125,000 in 1990 to 188,000 and 5,216,000 in 2010.
  • The proportion of low BMD in the total global burden nearly doubled from 0.12% in 1990 to 0.21% in 2010.
  • Approximately one-third of falls-related deaths were attributed to low BMD.

Conclusions:

  • Low BMD represents an escalating global health concern.
  • The current assessment of low BMD's health burden only partially reflects the true impact of osteoporosis.