Currently, an estimated 10 million Americans ≥50 years old have osteoporosis according to World Health Organization (WHO) criteria, while over 33 million more have “osteopenia” (analogous to “prediabetes”) the total number with low bone mass could reach 61 million by 2020. Growth of the elderly population will lead to dramatic increases in osteoporosis-related fractures in coming decades. The impact of these revisions on FRAX® is likely to be lowering of 10-year fracture probabilities, but more precise estimates of the impact of these changes will be available after these new rates are incorporated into the FRAX® tool. We recommend revising the US-FRAX by updating current base population values for hip fracture and major osteoporotic fracture. ResultsĬompared with rates used in the current FRAX® tool, 2006 hip fracture rates are about 16% lower, with greatest reductions observed among those below age 65 years major osteoporotic fracture rates are about one quarter lower, with similar reductions across all ages. To estimate the incidence of any one of four major osteoporotic fractures, we first summed these newly derived hip and vertebral fracture estimates with Olmsted County, MN, wrist and upper humerus fracture rates, and then applied 10–20% discounts for overlap. We used US hospital discharge data from 2006 to calculate annual age- and sex-specific hip fracture rates and age-specific ratios to estimate clinical vertebral fracture rates. In an attempt to correct this, we updated underlying fracture and mortality rates for the model.
IntroductionĮvaluation of results produced by the US version of FRAX® indicates that this tool overestimates the likelihood of major osteoporotic fracture. The impact of suggested changes is likely to be a lowering of 10-year fracture probabilities. On the basis of updated fracture and mortality data, we recommend that the base population values used in the US version of FRAX® be revised.
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