OSTEOPOROSIS


and one in fi ve men. Around 250,000 people in Scotland are living with the disease.


Women are particularly affected by the condition, particularly after the menopause when monthly periods stop. However, it can also sometimes affect men, younger women and children.


In most cases, the cause of osteoporosis in men is unknown. However, there’s a link to the male hormone testosterone, which helps keep the bones healthy. Men continue producing testosterone into old age, but the risk of osteoporosis is increased in men with low levels of testosterone. In around half of men, the exact cause of low testosterone levels is unknown.


OTHER GROUPS AT RISK OF OSTEOPOROSIS INCLUDE PEOPLE, WHO:


THE INCREASE IN THE GERIATRIC POPULATION IS BRINGING A RAFT OF NEW PROBLEMS FOR HEALTHCARE. ONE OF THEM IS THE RISE IN THE NUMBER OF PEOPLE AFFECTED BY OSTEOPOROSIS. SP TAKES A CLOSE LOOK AT THE SIGNIFICANT RISE IN THE PREVALENCE OF THIS DISORDER GLOBALLY.


OSTEOPOROSIS: THE INCREASING PREVALENCE


T


here is no doubt that older people with one or more long-term conditions such


as osteoporosis account for a large portion of spending by NHS Scotland.


Every year, hip fractures alone account for more than 7000 unplanned hospital admissions in Scotland and over 400,000 bed days in Scottish hospitals. It is estimated that such fractures cost approximately £206 million in hospital costs, excluding the high cost of social care.


These statistics are likely to rise in light of the ageing demographic, which will signifi cantly increase the proportion of the population, who have a low bone


40 - SCOTTISH PHARMACIST


density, and are therefore at risk of developing osteoporosis.


Perhaps unsurprisingly, the osteoporosis drug market is likely to increase incrementally, not only as a result of the increasing prevalence of the disease in post-menopausal women, but as a result of growing awareness about osteoporotic care and increasing investment in drug discovery and development.


WHAT IS OSTEOPOROSIS?


Osteoporosis is a condition that affects the bones, causing them to become weak and fragile and making them more prone to break or fracture. These


breaks most commonly occur in the wrist, hip and spine. It is estimated that, every year, people in the UK suffer more than 500,000 fragility fractures, ie, fractures that occur from standing height or less), often from just a minor bump or fall.


Osteoporosis is the most common reason for a broken bone among the elderly. Once the disease is diagnosed, however, the bones may weaken to such a degree that a break may occur with minor stress or even spontaneously.


Bones are at their thickest and strongest in early adult life and their density increases until the late 20s. After that, there is a loss of bone density from around the age of 35. While this happens to everyone, some people lose bone density much faster than normal, which means they’re at greater risk of a fracture.


WHO IS AFFECTED?


It is estimated that more than three million people in the UK are affected by osteoporosis: one in two women,


• have been taking steroid medication for more than three months (this can lead to a loss of bone density)


• have had their ovaries removed • have a family history of osteoporosis


• suffer from an eating disorder, such as anorexia or bulimia


• do not exercise regularly • smoke or drink heavily SYMPTOMS


Unfortunately, until a broken bone occurs, there are typically no symptoms. Although breaks happen most frequently in the wrist, hip or spine, they can also occur in other bones, such as in the arm or pelvis. Sometimes a cough or sneeze can cause a rib fracture or the partial collapse of one of the bones of the spine.


Although a fracture is usually the fi rst sign of osteoporosis, some older people develop the characteristic stooped (bent forward) posture, which happens when the bones in the spine have fractured, making it diffi cult to support the weight of the body.


DIAGNOSIS


If a doctor suspects osteoporosis, they generally make an assessment using an online programme, such as FRAX or Q-Fracture. Both of these tools help to predict a person’s risk of fracture between the ages of 40 and 90. The algorithms used give a ten-year


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