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BONE HEALTH NEGLECTED BY EUROPEAN WOMEN DESPITE AWARENESS OF OSTEOPOROSIS, NEW PAN-EUROPEAN HEALTH SURVEY SHOWS

NICE, France
June 5, 2004

European women aged over 50 want independent and active lifestyles but, despite awareness of the disease, neglect to take simple steps to prevent or treat osteoporosis

See summary of international survey: objectives and conclusions
English (PDF, 347 KB)
Spanish (PDF; 871 KB)

Despite a one in three risk that a woman over 50 will experience a fracture due to osteoporosis in her lifetimei, only half [53 percent] of European women over 50 surveyed considered themselves to be at risk, and only 25 percent had taken steps to have their bone health checked. More worrying, just 42 percent of these women, who may be at risk for developing post-menopausal osteoporosis, had discussed osteoporosis with their physician.

The nine-country survey was produced by International Osteoporosis Foundation (IOF) and European Institute of Women's Health (EIWH). It questioned women aged over 50 about their attitudes towards health issues that affect their lives. The results were announced today during a medical conference in Nice, France.

Panel speakers

"The results of this new survey are disturbing," observed Professor Jean-Yves Reginster, General Secretary of the IOF Board, who presented the findings. "It seems that the women surveyed do not connect knowledge about osteoporosis with the reality that they might personally be at risk. We have a significant educational task in front of us to reverse this perception that 'it can't happen to me."

Speaker J-Y Reginster Speaker J-Y Reginster, General Secretary, IOF

According to the survey, approximately 4.3 million* women aged 50-74 in the nine survey countries have suffered from at least one bone fracture since their 50th birthday as a result of a very minor fall. Of those who had suffered more than one fracture, less than a quarter [24 percent] were taking a prescribed medication for osteoporosis.

* This number was extrapolated based on population census data from the nine countries, 2001

Despite awareness of osteoporosis and the consequent risk of fractures, very few women over 50 understood the debilitating effect the 'brittle bone' disease could have on their lives: just 28 percent understood that the condition could leave them crippled, and only two percent considered the condition could lead to death. Whereas research has shown that up to one in five women who suffer hip fractures die within one year due to consequences of these fractures.ii Over a third of the women surveyed [39 percent] believed osteoporosis would affect their independence. Studies suggest that half of those who suffer hip fractures lose the ability to walk independently, and up to a third become completely dependent on caregivers.iii

As bone loss occurs without symptoms, osteoporosis can go undiagnosed and untreated for years until one or several fractures have occurred. In France, Germany, Italy, Spain and the UK, less than half the women with osteoporosis are diagnosed.iv

Only nine percent and 20 percent of the women surveyed had their height or weight regularly checked by their health care practitioner, respectively. Measurements of height and weight, as well as age, are simple, quick and cost-effective ways to assess a woman's risk of osteoporosis, and help to identify those who need further evaluation using a bone mineral density (BMD) test.

"Osteoporosis can greatly reduce women's ability to live active and independent lifestyles, which in turn has a huge impact on society. Given Europe's ageing population, particularly the number of older women, it is essential to continue to educate women of all ages about this disabling and neglected disease. The information/action gap has to be addressed, by providing information to women and healthcare providers on the prevention of osteoporosis," commented Peggy Maguire, Director General of the European Institute of Women's Health (EIWH).

A majority of women in our survey did not know about many basic steps that can be taken now to manage their bone health. Very few women know that vitamin D, which is readily available to most people, can play an important role in building strong and healthy bones.

Current guidelines strongly recommend vitamin D (and calcium) supplementation for postmenopausal women to help in the prevention and treatment of osteoporosis,v however according to a recent study, awareness of the efficacy of vitamin D is still low.vi

Both IOF and EIWH have collaborated on raising awareness of osteoporosis in the past. In 1998 a "Call to Action" based on the IOF audit report, "Osteoporosis in the European Community", was launched in the European Parliament.

Further survey findings on women's attitudes towards health

The survey, conducted in Finland, France, Germany, Holland, Ireland, Italy, Spain, Sweden and Switzerland, revealed additional information about the attitudes of women in this age group who may be at risk for osteoporosis. Post-menopausal women are at greatest risk, as are women with premature menopause.vii

Today's '50+ Woman' considered herself to be living a more active, independent lifestyle compared to her mother [73 percent]. Fifty six percent of the women questioned were either still working or being a house-wife/home-maker, and 42 percent were exercising at least three times a week. However, these same women are not taking their personal potential risk of osteoporosis after the menopause seriously.

Despite a large percentage [43 percent] of women surveyed fearing a hunched-over back, which is a common consequence of repeated vertebral fractures, only one in ten women considered strong bones to be one of the most important aspects of keeping the body looking strong and fit. Thus highlighting some of the knowledge gaps in women's understanding of the role bone health plays in general well-being.

Additional study data demonstrated that nearly nine in ten [87 percent] of the women surveyed whose mothers had osteoporosis believed that they were at risk of the condition. Genetic factors, particularly a family history of the disease, are key risk factors for developing osteoporosis.viii However, despite a quarter of them losing height over the last five years – loss of more than one inch is one of the earliest signs of osteoporosis – just 50 percent have ever been evaluated for osteoporosis using a bone mineral density test.

"The study results help shed new light into these complex issues and show that much work still needs to be done to educate and motivate women, particularly postmenopausal women, to take simple steps to prevent or lessen the impact of osteoporosis," noted Professor Helmut Minne, IOF chairman of the Committee of National Societies who also participated in the presentation. "But similarly we see that physicians have a major challenge to diagnose and treat osteoporosis more effectively."

Speaker Helmut Minne, Chairman of IOF's Committee of National Societies

The survey, 'How Health Issues Affect Today's Women Aged Over 50' was produced by IOF and EIWH and was supported by an unrestricted educational grant from Merck & Co., Inc.

The survey was presented during the 31st European Calcified Tissue Society annual meeting in Nice on 5 June 2004. The survey was conducted in May 2004 across nine European countries. The data sample analysed consists of 1,683 women aged 50-75 years.

About Osteoporosis

Osteoporosis, in which the bones become porous and break easily, is one of the world's most common and debilitating diseases. The result: pain, loss of movement, inability to perform daily chores, and in many cases, death. One out of three women over 50 will experience osteoporotic fractures, as will one out of eight menix. Unfortunately, screening for people at risk is far from being a standard practice. Osteoporosis can, to a certain extent, be prevented, it can be easily diagnosed and effective treatments are available.

Osteoporosis is second only to cardiovascular disease as a leading health care problem, according to the World Health Organization.

A woman's risk of osteoporosis can be determined by taking the simple IOF One-minute Risk Test, available on the IOF website: http://www.osteofound.org. An additional test, the OST tool, provides a similar quick assessment of a woman's osteoporotic risk factors based on height and weight variables, and also helps identify those who need further evaluation using a bone mineral density (BMD) test.

Notes to editors

  • Every 30 seconds, someone in the European Union has a fracture as a result of osteoporosis.x
  • 1 in 3 women and 1 in 8 men will suffer at least one osteoporotic fracture during their lifetime.i
  • The total annual cost of all osteoporotic fractures in the European Community is estimated at €25 billion.xi
  • Osteoporosis costs European Union national treasuries (including health insurances) over €4.8 billion annually in hospital healthcare alone.x
  • The number of osteoporotic fractures and their costs will increase at least two fold in the next 50 years unless effective preventive strategies are developed.xii
  • Worldwide, number of hip fractures could rise from 1.7 million in 1990 to 6.3 million by 2050. Most dramatic increase expected to be in Asia during the next decades.xiii
  • Osteoporosis afflicts an estimated one-third of women aged 60 to 70, and two-thirds of women aged 80 or older; approximately 200 million women worldwide suffer from osteoporosis.iii
  • For Caucasians, the lifetime risk of an osteoporotic fracture at 50 years of age has been estimated to be approximately 40% for women.i
  • In the first decade after the menopause, women may lose 15-20% of spinal bone and comparable amounts at other sites.xiv
  • Nine in 10 hip fractures occur in people over 50, 80% of them women.xv
  • Osteoporosis-related disability confines patients to more immobile days in bed than any of the following: chronic obstructive pulmonary disease, stroke, myocardial infarction or breast cancer.

About IOF

The IOF is a worldwide organization dedicated to the fight against osteoporosis. It brings together scientists, physicians, patient societies and corporate partners. Working with its 165 member societies in 85 locations, and other healthcare-related organizations around the world, IOF encourages awareness and prevention, early detection and improved treatment of osteoporosis.

About EIWH

The European Institute of Women's Health was established in 1993 as a non-governmental organisation, which seeks to have a positive influence on women's health throughout Europe. The Institute is concerned with highlighting European women's health needs through the following means: research, education and information dissemination.

Find out if you are at risk, take the IOF One Minute Risk Test at: www.osteofound.org

For further information, please contact
Paul Spencer Sochaczewski, Head of Communications,
International Osteoporosis Foundation:
Tel. +41 22 994 0100
Fax. +41 22 994 0101
E-mail: psochaczewski@osteofound.org

Peggy Maguire, Director General
European Institute for Women's Health
Tel: + 353 1 671 5691
Website: www.eurohealth.ie

References:

i Melton, L.J., 3rd, et al., Perspective. How many women have osteoporosis? J Bone Miner Res 1992, 7:1005-10.
ii NIH Consensus Development Panel on Osteoporosis Prevention: A Call to Action. An audit of policy development since 1998. Prepared by the International Osteoporosis Foundation, November 2001. www.osteofound.org
iii US Congress. Office of Technology Assessment: Hip fracture outcomes in people aged fifty and over. Background paper. OTA-BP-H-120 Washington DC: US Government Printing Office, July 1994
iv International Osteoporosis Foundation. http://www.osteofound.org/press_centre/fact_sheet.html
v European Commission (1998) Report on osteoporosis in the European Community: action on prevention. Luxembourg Office for Official Publications of the European Communities, p 112.
vi Boonen, S., et al. The need for clinical guidance in the use of calcium and vitamin D in the management of osteoporosis: a consensus report. 2004. International Osteoporosis Foundation and National Osteoporosis Foundation 2004.
vii International Osteoporosis Foundation. The Facts About Osteoporosis and its Impact.
viii Kanis, J.A., Diagnosis of osteoporosis and assessment of fracture risk. Lancet 2002, 359:1929-36.
ix Melton U, Chrischilles EA, Cooper C et al. How many women have osteoporosis? Journal of Bone Mineral Research, 1992; 7:1005-10
x Compston, J. et al. Fast Facts-Osteoporosis. 2nd ed. 1999. Oxford Health Press Ltd. 2001 IOF Call To Action
xi http://www.osteofound.org/press_centre/pr_2003_11_12.html, dated 1 June 2004
xii Report on osteoporosis in the European Community – Action for prevention. Published by the European Commission in 11 languages. Manuscript completed in 1998. CE-09-97-915-EN-C. www.osteofound.org/activities/eu_summary_report.html, dated 1 June 2004
xiii Cooper, C., et al., Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992, 2:285-9.
xiv European Institute of Women's Health. Women in Europe towards healthy ageing: A Review of the health status of mid-life and older women. 1996.
xv Department of Health (England). Report of the Advisory Group on Osteoporosis. London: Department of Health 1994.

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