A few days before World Osteoporosis Day, experts point out the gaps in the management of this disease and call on the public authorities to mobilize.
Sneaky and silent, osteoporosis often only manifests itself when a fracture occurs. This bone disease appears around the age of 50 and affects one in three women and one in five men. In more than half of these people, a first osteoporotic fracture announces new fragility fractures. And yet, more than 80% of patients do not receive adequate treatments to slow down bone destruction, worries the International Osteoporosis Foundation in a report published on the eve of World Day to be held on October 20.
Worldwide, it is estimated that an osteoporotic fracture happens every 3 seconds. In France, some 377,000 fractures are attributable to this skeletal disease. The hip, the vertebrae, the wrist are the most affected bones. “A tsunami of fractures is coming, and the weight of this human and socio-economic scourge will have a huge impact in all countries with an aging population,” warns Professor Eugene McCloskey, one of the authors of the report and doctor at Nothern General Hospital (Kingdom -United). The consequences of fragility fractures can be deeply disabling, with chronic pain and disability that can affect mobility and quality of life. Less than half of seniors who survive a hip fracture will be able to walk on their own again, and more than 20% will have to live in a retirement home one year after their fracture ”.
Ten gaps to fill
However, the authors of the report stress that it is possible to avoid “this catastrophe” if the prevention and the management of patients with osteoporosis were improved. To succeed, it would be necessary to fill the 10 gaps identified by experts on a global scale and divided into 4 main themes: screening and treatment, public awareness, government action and epidemiology.
Firstly, they believe that a considerable effort must be made to better detect secondary fractures, osteoporosis induced by drugs or that associated with other pathologies, as well as the screening of people at high risk of osteoporosis in order to prevent the first fracture. The establishment of a network between geriatricians and rheumatologists, and the deployment of screening by bone densitometry could improve these black spots.
Source: BONE HEALTH GAPS AND SOLUTIONS: Global Framework for Improvement, Report of the International Osteoporosis Foundation, October 2016.
No more time to wait
They also deplore that “public awareness of osteoporosis and the resulting fragility fractures is poor in many countries”. It is therefore “urgent” to set up prevention campaigns based on “clear, coherent and convincing messages around bone health”. These could promote physical activity, a factor recognized as a protective factor, a diet rich in calcium – children and adolescents must receive 1200 mg of calcium per day – or cessation of smoking.
Actions which require that the public authorities become aware of the current and future burden of osteoporosis, underlines the report. For its authors, this disease should now enjoy the attention of governments in the same way as other chronic diseases. “Access to treatment cannot be hampered by the lack of access to bone densitometry or by inadequate treatment reimbursement policies”, they judge, adding that “the prevention of osteoporosis and fragility fractures should be a national public health priority in all countries. Measures are needed today, and not in 10 or 20 years when it will already be too late to act ”.
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