US Pharm. 2019;44(9):15.

According to the National Osteoporosis Foundation, roughly 54 million Americans aged 50 years or older have low bone mass (43.4 million) or osteoporosis (10.2 million), equating to more than one-half of the U.S. population aged 50 years or older. Eighty percent of U.S. adults with osteoporosis are female, and one in two women aged 50 years or older will suffer an osteoporosis-related bone fracture. A woman’s risk of breaking a hip is equal to her combined risk of breast, uterine, and ovarian cancer.

Clinical Risk Factors: The CDC and the National Center for Health Statistics used National Health and Nutrition Examination Survey data from 2013 to 2014 to estimate Fracture Risk Assessment Tool scores for the 10-year probability of hip fractures and major osteoporotic fractures (MOFs). Based on lifestyle and health-history risk factors, the probability of hip fractures and MOFs was two to seven times higher in women than in men. In women, the probability of elevated hip fracture and MOF was 24.7% and 14.1%, respectively. Previous fracture was the most common clinical risk factor, followed by high daily alcohol intake and smoking. About 50% of white, Asian, and Hispanic women and 35% of African-American women had low bone mass. The prevalence of elevated probability of both fracture types increased significantly between ages 40 and 49 years and age 80 years or older, respectively, from 0.1% to 2.4% for hip fracture and 2.59% to 11.35% for MOF. Compared with women aged 40 years or older, 19% of those aged 50 years or older had an elevated hip fracture probability and 8% had an elevated probability of MOF.

Hip Fractures: The probability of hip fracture among women varied significantly according to race: non-Hispanic white women (2.13%) were most affected, followed by multiracial (1.86%), non-Hispanic Asian (1.35%), Hispanic (1.04%), and non-Hispanic black women (0.56%). The probability of elevated hip fracture increased from 7% in women aged 50 to 59 years to 72% in those aged 80 years or older. In adults with an elevated probability of hip fracture, 67% had low bone mass and 30% had osteoporosis at the femoral neck.

MOFs: Osteoporosis prevalence in women aged 50 years or older varied by race: 20% in both non-Hispanic white and Asian women, 10% in Hispanic women, and 5% in black women. MOF probability was 6% in women aged 40 years or older and 9.8% in those aged 50 years or older. Elevated probability of MOF increased from 3% in the youngest age group to 27% in the oldest group. In women with elevated MOF, probability was 53% for those with low bone mass and 42% for those with femoral-neck osteoporosis.

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