ABSTRACT
This chapter describes the burden placed on individuals, healthcare systems and societies globally by osteoporotic fractures. Osteoporosis constitutes a major public health problem, through its association with age-related fractures, particularly of the hip, vertebrae, distal forearm and humerus, with serious consequences in terms of morbidity and mortality. Hip fractures increase exponentially with age in most populations, having a female to male incidence ratio of around two to one, with around 98" occurring among people aged 35 years or over, and 80" occurring in women. Vertebral fractures, are more difficult to quantify than hip fractures, mainly because they are often asymptomatic and there are disagreements about the radiographic definitions of vertebral deformities. Wrist fracture rates increase gradually with age, in contrast to the exponential increases in hip fractures at older ages. Global variation in fracture incidence is best documented for hip fracture, and studies have shown marked heterogeneity in annual age-standardized hip fracture rates.
