Osteoporosis - socioeconomic aspects / Монголын Анагаах Ухаан

ABSTRACT

Osteoporosis and the fractures associated with it constitute a major public health concern. Osteoporosis is a systemic skeletal disease characterized by low bone density and microarchitectural deterioration of bone tissue with a consequent increase in bone fragility. A WHO Scientific Group on April 2000 estimated osteoporosis is well-defined disease that affects more than 75 million people in Europe, Japan and the USA, and causes more than 2.3 million fractures annually in Europe and the USA.In Europe, for example, the number of women over 50 years of age is projected to increase by 30%-40% between 1990 and 2025.Most studies suggest the required daily intake is between 1000 mg and 1500 mg in postmenopausal women not taking estrogen replacement therapy. This can be obtained from about three serves of dairy products per day. For example, one glass (250 mL) of milk, two slices (40 g) of Cheddar cheese, or one tub (200 g) of yoghurt each contains about 300 mg of calcium. In one French study involving vitamin D deficient institutionalized elderly patients, simple vitamin D3 (800 IU) and calcium (1200 mg/day) reduced hip fractures by 43%.The management of postmenopausal osteoporosis should be based on an individual risk/benefit analysis, time since menopause, presence or absence of estrogen with drawal symptoms, history of atraumatic fractures, and other medical conditions. Socioeconomic evaluation of osteoporosis can be undertaken to estimate the cost of disease, the effectiveness of treatments, and the effects of strategies to identify patients at high risk such as screening and case-finding, or to assess global strategies. Global strategies aimed at increasing the BMD of the general population have not been adequately tested, but general advice on lifestyle is an important component of patient care.