مقاله انگلیسی رایگان در مورد نظارت و درمان پوکی استخوان – الزویر 2020

1. Background

2. Screening and Diagnosis

3. Management of Osteoporosis and Osteopenia

4. Conclusion

References

Abstract

Osteoporosis and poor bone health effects approximately 200 million people worldwide, with numbers expected to increase as the population ages. Increases in osteoporosis and poor bone health are associated with increased fragility fracture rates, increased morbidity and mortality, and a huge economic burden. Osteoporosis screening and treatment guideline recommendations are currently underutilized resulting in a public health concern. This article describes current osteoporosis screening recommendations, pharmacological interventions, and a collaborative approach to treatment.

Background

Osteoporosis is the most common human bone disease.4 An estimated 10.2 million Americans are living with osteoporosis and 43.4 million more Americans have low bone density, which accounts for 54% of the over-age-50 population. The US prevalence of osteoporosis and osteopenia combined is 35.5 million in women and 18.2 million in men. Osteoporosis and osteoporotic fragility fractures are a growing concern worldwide and are expected to increase with the aging population,1 with an estimated increase of 10.4 million (19%) by 2020 and 17.2 million (32%) by 2030.2 Approximately 50% of Caucasian females and 20% of males will experience an osteoporotic-related fracture of the hip, wrist, or spine in their lifetime.4,5 Although the number of men with osteoporosis is lower than the number of women with the disease, the incidence of fractures in males with osteoporosis is higher than the risk of fracture in women with osteoporosis,6 at least partially owing to gender inequalities in testing and treatment.

Mortality following hip fracture is 2.8 to 4.0 times greater in the first 3 months postfracture than in similarly aged individuals without a hip fracture. Hip fracture survivors often experience a downward spiral in physical and mental health. After a hip fracture, 80% of patients are unable to perform basic tasks, 64% require a stay in a nursing home, and 20% will remain in a nursing home for the remainder of their life. In patients with hip fractures, 40% never regain their prefracture level of function.4,8 Many experience isolation, depression, and fear of falls with subsequent fractures. These mental health issues often elevate to the point of incapacitation.4,8 Hip fractures create a huge economic burden as well. More than $20 billion in health care is spent on osteoporosisrelated hip fractures annually.