Recent studies reveal significant underdiagnosis and undertreatment of osteoporosis and osteopenia in older adults, despite rising fracture rates and high post-fracture mortality. These findings highlight the urgent need for improved screening, treatment, and fracture care as Australia prepares for a growing disease burden projected from 2024 to 2033.
Healthy Bones Australia updated their previous Burden of Disease Analysis undertaken in 2012. Their 2023 report shows an increase in the disease prevalence and associated costs.
Poor bone health
- 6.2 million, or 67%, Australians aged 50 years and older have poor bone health in 2023. This is a 34% increase from 2012.
- Of the 6.2 million Australians with poor bone health, 77% had osteopenia, and 23% had osteoporosis in 2023.
- Of the population aged 50 years and older 52% of all minimal trauma fractures were related to osteopenia.
- The highest number of fractures were in osteoporosis women aged 70 years and older.
- In 2023, 125,696 (65%) of people who had a minimal trauma fracture were hospitalised, and the majority were due to a hip fracture. The average acute hospital length of stay for hip fracture was 10.3 days, and for rehabilitation, it was 22.45 days.
The Fracture Cascade
About 50% of people with one fracture due to osteoporosis will have another. The risk of future fractures rises with each new fracture, the ‘cascade effect’.
The ‘cascade effect’ means that women who have suffered a fracture in their spine are over 4 times more likely to have another fracture within the next year, compared to women who have never had an osteoporotic fracture.
People who have had two or more osteoporotic fractures are up to 9 times more likely to have another fracture, rising to an 11 times greater risk for people who have had three or more fractures, compared to someone who has not had one.
1 in 2 women and 1 in 3 men over 60 years will have an osteoporotic fracture in Australia..
High fracture rates
- In 2023, there were an estimated 193,482 osteoporosis and osteopenia-related fractures.
- By 2033, this number of fractures is projected to increase by 34%, resulting in 237,632 fractures.
- In 2023, there was one fracture every 2.7 minutes in Australia. This will rapidly increase to 1 fracture every 30 seconds by 2033.
- The estimated total number of fractures over the next ten years, including new fractures and re-fractures, is over 2.1 million
Future prevalence and burden cost
By 2033, 7.7 million Australians aged 50 years and older are predicted to have osteoporosis and osteopenia. An increase of 23% from 2023 and 69% since 2012.
Osteoporosis and osteopenia in women 70 years and older are predicted to increase by 41%, followed by 39% predicted growth in men 70 years and older.
The largest single population group by 2033 will be men aged 50 – 69 years with osteopenia (16%), followed by women aged 50 – 69 years with osteopenia (15%). There is an increased disease burden on men. The increase in refractures in 2024-2033 was highest among men (12% in aged 50-69 years and 31% in age 70 years and older) compared to women (4% in aged 50-69 years and 25% in age 70 years and older).
The economic burden associated with osteoporosis and osteopenia among Australians aged 50 years and older is significant ($4.8 billion in 2023 and $8.3 billion in 2033). The costs associated with fractures is the largest component cost of the disease and total direct costs represent 91% of total costs.
Total cost of osteoporosis, osteopenia and fractures over 10 years estimated at $67.9 billion.
Source and credit: Healthy Bones Australia, Osteoporosis and fractures in Australia. A burden of disease analysis, 2023-2033.