|
|
The primary clinical consequence of osteoporosis is fracture. Both vertebral and hip fractures can have a significant impact on morbidity and mortality. It is estimated that 1 out of every 3 women over the age of 65 suffers a vertebral fracture, and once vertebrae are deformed, they never return to their normal shape; such deformities can accumulate over time, leading to kyphosis and chronic back pain. Dorsal kyphosis can result in restriction of volume of the thoracic cavity, and compression of the thoracic cavity. In addition, due to a loss of spinal mobility that results from vertebral deformity, many individuals with osteoporosis are unable to perform activities of daily living such as bathing, dressing, walking, rising from a chair, carrying items, and standing. Similarly for hip fractures, a large percentage of individuals who have sustained a hip fracture are unable to function independently and many require nursing home care. In both cases, the decreased activity that results from limited mobility in turn can lead to a further decline in BMD and an increased risk of falls and fractures.
Because of the limitations on physical function, many patients with osteoporosis may feel a sense of hopelessness and helplessness in not being able to perform many of the activities of daily living. Some may also experience feelings of low self-esteem, whether due to physical appearance or an inability to function normally, and may withdraw from social interactions. Feelings of depression, fear, and anxiety may also occur.
Osteoporotic fractures also incur a significant financial burden. It is estimated that the total annual healthcare costs for the treatment of osteoporosis-related fractures is approximately $14 billion. Interestingly, fractures at skeletal sites other than the hip account for over one-third of the total attributed healthcare costs, a contribution that has been underestimated in the past.
|
|
|
