Latin America

Osteoporosis is growing in incidence and prevalence in Latin America. According to WHO projections, over the next 50 years, there will be an increase in the population aged 65 and older such that the number of hip fractures will be similar to numbers in Europe and the United States.

Unfortunately in Latin America, resources in terms of adequate medical facilities for osteoporosis diagnosis and treatment are inadequate and, in most countries, there are no policies in place to ensure reimbursement of densitometry tests or medication.

Epidemiology

In order to increase awareness of the growing problem osteoporosis represents for the region it is necessary to target not only the general population, but also to draw the attention of health professionals and politicians and be able to exert influence on both the public and private healthcare systems, encouraging them to develop specific osteoporosis awareness, prevention and treatment programs. IOF works closely with its members in Latin America in order to ensure that osteoporosis awareness becomes a priority.

With new research studies and a growing body of epidemiological data, many countries in Latin America are now able to quantify the burden of osteoporosis. For example, a major epidemiological review was published for Argentina (May 2010) in the journal Archives of Osteoporosis. Download:

'Epidemiology, costs, and burden of osteoporosis in Argentina, 2009' by F.R. Spivacow (PDF, 154.9 KB). IOF is supporting the publication of similar studies in other Latin American countries.

IOF supports the Latin American Vertebral Osteoporosis Study (LAVOS), a project which covers 11 countries. The project has already produced a final protocol including standardization procedures for the questionnaire, x-rays, bone densitometry. An operation manual has also been developed. Infrastructure has been set up, including a morphometry centre in Mexico, a DXA quality assurance (QA) centre in Brazil and a coordinating centre established in Mexico.

A report on the burden of osteoporosis in Latin America can be found in the following publication:

Morales-Torres J, Gutierrez-Urena S, Osteoporosis Committee of Pan-American League for Associations of Rheumatology. The burden of osteoporosis in Latin America. Osteoporos Int 2004;15(8):625-32. Click here to download PDF of this article. (PDF, 205.4 KB)

Key facts and statistics for this region

From 1990 to projections in 2050 the number of hip fractures for women and men aged 50-64 in Latin America will increase by 400%. For age groups older than 65 the increase will be a staggering 700% (25).
Latin Americans will suffer an estimated 655,648 hip fractures in 2050, at an estimated direct cost of $13 billion (147). The mortality rates in the year following a hip fracture are 23-30% and are higher in men compared to women (239,240).
The prevalence of vertebral osteopenia in women 50 years and older has been reported at 45.5-49.7% and vertebral osteoporosis at at 12.1-17.6%; while the prevalence of femoral neck osteopenia has been reported at 46-57.2% and femoral neck osteoporosis at 7.9-22% (239).
In a study of five Latin American countries (Argentina, Brazil, Colombia, Mexico and Puerto Rico), the prevalence of vertebral fractures in women over 50 years of age was about 15%, with 7% occuring within the 50-60 years old age group and increasing to 28% for those greater than 80 years old (190).
Argentina: The prevalence in women over 50 years old is 50% for osteopenia and 25% for osteoporosis (241). It is projected that by 2050, 5.24 million and 2.62 million women will have osteopenia and osteoporosis, respectively (242).
Argentina: 34,000 hip fractures occur every year in the population aged 50 years and older, with an average of 90 fractures/day. By 2050, there will be >63,000 hip fractures in women and >13,000 in men (243). The prevalence of vertebral fractures in these women is 16.2% (190). Hospitalization costs of hip and vertebral fractures exceed 190 million USD per year (243).
Brazil: 10 million people, approximately one person in every 17, has osteoporosis (148). The lifetime prevalence of fractures has been found to be 37.5% among men and 21% among women with proportions among white, mixed and black subjects at about 29%, 31% and 22%, respectively (191).
Brazil: It is estimated that just 1 in 3 patients with hip fractures are diagnosed as having osteoporosis and of those, only 1 in 5 receive any kind of treatment (196).
Brazil: The economic burden of osteoporosis hip fractures to private health plan companies in Brazil is estimated in the region of $6 million (195).
Chile: In 1985, a large clinical trial of women older than 50 indicated that 46% had osteopenia and 22% had osteoporosis (149).
Mexico: 1 out of every 4 people has osteopenia or osteoporosis (150) and the lifetime probability of having a hip fracture at 50 years of age is 8.5% for women and about 4% for men (192). For 2006, the estimated cost of healthcare for hip fracture was $97 million (193).
Venezuela: The lifetime probability of having a hip fracture at 50 years of age is 5.5% for women and 1.5% for men, and for any osteoporotic fracture is 13.6% for women and 3.5% for men (240).
Venezuela: In 1995 there were 9.6 hip fractures per day. In 2030 it is estimated that there will be 67 hip fractures per day. Of the people that suffer a hip fracture, 17% die in the first 4 months after the fracture. Clinical trials indicated that only the 10% of the population older than 70 years have normal peak bone mass (151).

Guidelines

See list of guidelines from countries in Latin America.

If you represent a national osteoporosis society and your country or region has evidence-based guidelines that you would like to include on the IOF website, please contact Prof. J. E. Compston at info@iofbonehealth.org

IOF does not officially endorse national or regional guidelines. This is because osteoporosis prevalence and some aspects of the prevention and treatment of fractures are country or region-specific. There may be multiple guidelines from any one country or region.

See listing of national and regional guidelines around the world, including references and links to full text.