4
2. Osteoporosis Treatment
Although osteoporosis is more common in women than in men, the incidence in men is also increasing. The disability, mortality, and cost of
hip and vertebral fractures are substantial in the rapidly growing, aging population so that prevention and treatment of osteoporosis is a major
public health concern Meyer et al., 2000 No certain treatment is yet available for osteoporosis once it is
established. Fluoride, which stimulates bone formation, may decrease bone resorption but do not necessarily increase bone mass and therefore prevent
further fractures. Recent evidences have, however, suggested that estrogen treatment in osteoporotic women significantly increases spinal bone mass
and reduces the rate of vertebral fracture Albertsson et al., 2007.
3. Osteoporosis Fractures
Osteoporosis is based on the major risk factor such as reduced bone strength or density, which includes those individuals at a high risk but
without fractures. Despite the use of a „„bone mass‟‟ definition, it is important to realize that bone density is a single risk factor, measured at a
single point of time. Other risk factors include aging, being female, life expectancy, bone loss, bone turnover, low body weight, low sex hormones
or menopause, smoking, and some medications also have important considerations.
As bones become more brittle with age due to bone mass loss, there is a greater risk of incurring an osteoporosis fracture. Approximately
commit to user
5
40 of women and about 10- 15 of men suffer from fracture, especially of vertebral bodies, the femur and the forearm. The estimated incidence of
femoral neck fractures is about 1.66 million per year worldwide. As life expectancy goes up, the incidence of osteoporosis increases four fold
Roche Diagnostics, 2009. Fractures due to skeletal fragility in elderly people are an
increasing public health issue worldwide, and the devastating medical and social costs can be expected to increase unless effective prevention and
treatment regimens are developed. Hip fracture is the most severe complication of osteoporosis, placing the greatest demand on resources
and having the great impact on patients because of increased mortality, long-term disability and loss of independence Willig et al., 2001.
Exercise has been shown to be essential for maximizing peak bone mass and reducing subsequent bone loss Beck et al., 2003. In
premenopausal women, high-impact exercise has been suggested to be the most effective regimen.
4. Epidemiology of Osteoporosis
The incidence of osteoporosis and resulting osteoporotic fractures is increasing.
Worldwide Epidemiology
Data demonstrate that Caucasian or Asian women are more susceptible to the osteoporosis. Both genetic and behavioral risk factors
contribute to the development of osteoporosis Piaseu and Belza, 2001. perpustakaan.uns.ac.id
commit to user
6
A report from WHO Consensus Development Conference in 2000 Consensus Development Conference 1991 described that in the
United States there are approximately 1.3 million patients suffering from osteoporotic fractures per year. Among these, about 50 had
vertebral fractures, another 25 had hip fractures and the last 25 had wrist fractures or others. Additionally, there were reports stating that
about 30 of European women who were 50 years old or more had osteoporosis. According to the United States National Health and
Nutrition Survey NHANES III in 1997, there was an estimate that 13- 18 of female American Caucasian having osteoporosis while 27-50
of all American Caucasian women had osteopenia, which enhanced the rate of onset for osteoporosis in these women when they become older.
On the other hand, looking only at the American Caucasian female population aged 80 or more, about 70 of them will have osteoporosis.
In general, bone fractures are much more prevalent in men than in women since from adolescence to middle age men‟s lifestyle and
activities are generally more physically intense, including some activities that are more risky andor more dangerous than those that are
common to women. It was found that men experienced bone fracture as the consequences of high-energy trauma. However, after the age of 40-
50 bone fracture incidence seems to be totally opposite to what occurs with females. Bone fractures from various parts of the body such as
commit to user
7
wrists, vertebra, pelvis and hip in women are substantially increased Melton et al., 1992.
In these cases fractures are the results of low-energy trauma; in other words, they are osteoporotic fractures. In the United States, there
are about 500,000 cases of spinal fractures per year Melton et al., 1992 and there are ten times more prevalent in women than in men. It
can be said that half of American Caucasian females age of 70 or more have fractures at one or more vertebrae. For hip fractures, the incidence
rate in the Caucasian female population ranged from the highest, 737 fractures per 100,000 population per year for Norwegian females, to the
lowest, of 280 fractures per 100,000 population for Finnish women Maggi et al., 1991.
Epidemiology in Asia
The incidence rates in Asian countries are increasing every year. For example, with Hong Kong Chinese females, the incidences for hip
fracture almost doubled from 179 fractures per 100,000 population in 1965 to 389 fractures per 100,000 population in 1985 Lau, 1997.
Recently in Japan, a study shows that the incidence of hip fractures rose from a total of 92,400 cases from 1997 to 2001 to 117,900 yearly
Orimo Nakamura and Fukunaga, 2006. There is also an estimation of more than 6 million cases of hip fracture occurring worldwide in 2050
and half of these, or 3 million cases, will happen in Asia Lau, 1997. perpustakaan.uns.ac.id
commit to user
8
5. Physical Activity
Kategori