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Osteoporosis in Men

  • About 20-25% of hip fractures related to Osteoporosis occur in men.

  • The overall mortality is about 20% in the first 12 months after hip fracture and is higher in men than women (13,14)

  • It is estimated that the residual lifetime risk of experiencing an osteoporotic fracture in men over the age of 50 is up to 27%, higher than the lifetime risk of developing prostate cancer of 11.3% ( 255,15).

  • Vertebral fractures may cause equal morbidity in men and women. Hip fractures in men cause significant morbidity and loss of normal functioning (16).

  • Although the overall prevalence of fragility fractures is higher in women, men generally have higher rates of fracture related mortality (14,17).

  • As in women, the mortality rate in men after hip fracture increases with age and is highest in the year after a fracture (18,19). Over the first 6 months, the mortality rate in men approximately doubled that in similarly aged women (18).

  • Forearm fracture is an early and sensitive marker of male skeletal fragility. In aging men, wrist fractures carry a higher absolute risk for hip fracture than spinal fractures in comparison to women (20).

  • In Sweden, osteoporotic fractures in men account for more hospital bed days than those due to prostate cancer (21).

  • In 2025, the estimated number of hip fractures occurring worldwide in men will be similar to that observed in women in 1990 (244).

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Osteoporosis – General

  • Worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every 3 seconds (214)

  • Osteoporosis is estimated to affect 200 million women worldwide – approximately one-tenth of women aged 60, one-fifth of women aged 70, two-fifths of women aged 80 and two-thirds of women aged 90 (240).

  • Osteoporosis affects an estimated 75 million people in Europe, USA and Japan (1).

  • For the year 2000, there were an estimated 9 million new osteoporotic fractures, of which 1.6 million were at the hip, 1.7 million were at the forearm and 1.4 million were clinical vertebral fractures. Europe and the Americas accounted for 51% of all these fractures, while most of the remainder occurred in the Western Pacific region and Southeast Asia (214).

  • Worldwide, 1 in 3 women over age 50 will experience osteoporotic fractures, as will 1 in 5 men aged over 50 (2,3,4).

  • 80%, 75%, 70% and 58% of forearm, humerus, hip and spine fractures, respectively, occur in women. Overall, 61% of osteoporotic fractures occur in women, with a female-to-male ratio of 1.6 (214).

  • Nearly 75% of hip, spine and distal forearm fractures occur among patients 65 years old or over (5).

  • A 10% loss of bone mass in the vertebrae can double the risk of vertebral fractures, and similarly, a 10% loss of bone mass in the hip can result in a 2.5 times greater risk of hip fracture (6).

  • By 2050, the worldwide incidence of hip fracture in men is projected to increase by 310% and 240% in women (7).

  • The combined lifetime risk for hip, forearm and vertebral fractures coming to clinical attention is around 40%, equivalent to the risk for cardiovascular disease (8).

  • Osteoporosis takes a huge personal and economic toll. In Europe, the disability due to osteoporosis is greater than that caused by cancers (with the exception of lung cancer) and is comparable or greater than that lost to a variety of chronic noncommunicable diseases, such as rheumatoid arthritis, asthma and high blood pressure related heart disease (214).

  • A prior fracture is associated with an 86% increased risk of any fracture (10).

  • Although low BMD confers increased risk for fracture, most fractures occur in postmenopausal women (56,168,169) and elderly men (170) at moderate risk.

  • In women over 45 years of age, osteoporosis accounts for more days spent in hospital than many other diseases, including diabetes, myocardial infarction and breast cancer (11).

  • Evidence suggests that many women who sustain a fragility fracture are not appropriately diagnosed and treated for probable osteoporosis (84,85).

  • The great majority of individuals at high risk (possibly 80%), who have already had at least one osteoporotic fracture, are neither identified nor treated (86).

  • An IOF survey, conducted in 11 countries, showed denial of personal risk by postmenopausal women, lack of dialogue about osteoporosis with their doctor, and restricted access to diagnosis and treatment before the first fracture result in underdiagnosis and undertreatment of the disease (12).

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