Most Women Unaware of Risk for Debilitating Fractures

Underscoring what researchers call a serious global public health concern, results from a new study led by Columbia University Medical Center reveal that many women at an elevated level of risk for osteoporosis-associated fractures fail to perceive the implications of the risk factors.

“We found that many women aren't making the connection between their risk factors and the serious consequences of fractures,” said the lead author Ethel Siris, M.D., director of the Toni Stabile Osteoporosis Center at NewYork-Presbyterian Hospital/Columbia University Medical Center, and the Madeline C. Stabile Professor of Clinical Medicine at Columbia University College of Physicians and Surgeons. “Without a clear understanding of their risks, women cannot begin to protect themselves from fracture.”

This study, part of the Global Longitudinal Study of Osteoporosis in Women (GLOW), which is based at the Center for Outcomes Research at the University of Massachusetts Medical School, was published online by the journal Osteoporosis International on April 2, 2010.

The study, conducted at 17 GLOW study sites worldwide, included more than 60,000 postmenopausal women in 10 countries in Europe, North America and Australia.

Results showed that among postmenopausal women diagnosed with osteoporosis – a condition associated with a high risk for fractures, as it causes bones to become fragile and more likely to break – only 43 percent thought their risk of a fracture was higher than other women their age. Additionally, only one in three (33 percent) women who reported two or more major risk factors for fracture, perceived themselves as being at higher risk for fracture than their age-matched peers.

Because many fractures can be prevented by appropriate treatment, it is important that elevated risk be recognized.

One in two women will suffer an osteoporosis-related fracture after age 50; these fractures often carry with them chronic pain, reduced mobility, loss of independence and in the case of hip fracture, an increased risk of death. Because the likelihood of fractures increases substantially with age, fracture numbers are projected to rise as the population ages. Osteoporosis-related fractures are an international public health problem; in addition to the human suffering associated with these fractures, they also are the source of enormous health-care costs.

Improved education of physicians and postmenopausal women about osteoporosis risk factors is urgently needed, according to the study authors. If left untreated, osteoporosis can progress painlessly until a fracture occurs. Several risk factors for fractures have been identified and should be considered by physicians treating women age 55 and older:

- older age
- low weight
- parental hip fracture
- personal history of fracture (clavicle, arm, wrist, spine, rib, hip, pelvis, upper leg, lower leg, ankle) since age 45- two or more falls in the past year- current use of cortisone or prednisone (steroids often prescribed for a number of medical conditions)- rheumatoid arthritis- cigarette smoking- consumption of three or more alcoholic beverages daily