Impact
Osteoporosis has a severe and often underestimated impact in terms of human cost and socioeconomic burden.
The human cost
Fractures resulting from osteoporosis cause suffering and disability, with great impact on a person’s quality of life.
- Hip fractures are invariably associated with chronic pain, reduced mobility, disability, and an increasing degree of dependence. After sustaining a hip fracture 10-20% of formerly community dwelling patients require long term nursing care, with the rate of nursing home admission rising with age.
- Hip fractures cause the most morbidity with reported mortality rates up to 20-24% in the first year after a hip fracture, and greater risk of dying may persist for at least 5 years afterwards. Loss of function and independence among survivors is profound, with 40% unable to walk independently, 60% requiring assistance a year later. Because of these losses, 33% are totally dependent or in a nursing home in the year following a hip fracture.
- Vertebral fractures can lead to back pain, loss of height, deformity, immobility, increased number of bed days, and even reduced pulmonary function. Their impact on quality of life can be profound as a result of loss of self-esteem, distorted body image and depression. Vertebral fractures also significantly impact on activities of daily living.
- After hospitalization for a vertebral fracture, there is a greatly increased risk of requiring hospitalization for a further fracture in the years following initial hospitalization.
- While in western countries the outcome of hip fractures is severe, the outcome in other parts of the world may be even more devastating. Only a few non-western reports are available, but the example of Russia shows how dire the situation can be. In Russia, many patients with hip fracture never receive surgery, leading to permanent walking disability in the best case and death in the all-too-frequent worst case (Lesnyak O et al. Social impact of hip fractures in Russia. Osteoporosis Int 2000; 11 suppl 5:S4 Lesnyak O., 2001).
See references and further facts and statistics
Download the IOF thematic report: Quality of Life
Qualeffo-41
Quality of Life Questionnaire
This osteoporosis disease-specific, thoroughly validated questionnaire has been used by health professionals to measure the health-related quality of life of osteoporotic patients with vertebral fractures in the context of a survey or clinical study. See Quality of Life / Qualeffo41 questionnaire
The 14 of 41 questions of Qualeffo-41 that best distinguish patients with osteoporosis from control subjects of a similar age are:
- How often have you had backpain in the last week?
- How severe is your back pain at its worst?
- How is your back pain at other times?
- Do you have problems with dressing?
- Can you do the cleaning?
- Can you prepare meals?
- Can you wash the dishes?
- Can you get up from a chair?
- Can you bend down?
- Can you climb stairs to the next floor of a house?
- Have you been affected by the changes of your figure due to osteoporosis (for example loss of height, increase of waist measurement, shape of your back)?
- Can you do your gardening?
- For your age, in general, would you say your health is: excellent, good, satisfactory, fair or poor?
- Do you feel full of energy?
The socioeconomic impact
Osteoporosis also represents a major socioeconomic burden. Escalating direct costs for health and hospital care are paralleled by the rising indirect costs that result when patients lose their independence and require nursing care. The ageing of the population in most countries, and especially in Asia and Latin America, will increase the overall burden of osteoporosis tremendously.
A 2002 IOF report estimated that the annual combined medical costs of treating 2.3 million osteoporotic fractures in both Europe and United States was $27 billion. (Osteoporosis in the Workplace, 2002).
Already, in many countries, fractures caused by osteoporosis are responsible for more days of hospitalization among women over 45 years of age than any other disease. The graphs below, based on European and worldwide studies, show the burden of the disease compared to other disease states.
