Epidemiology of osteoporosis

Published on January 19, 2015   31 min

Other Talks in the Series: Bone in Health and Disease

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The Epidemiology of Osteoporosis, Professor Cyrus Cooper, professor of rheumatology and director, MRC Lifecourse Epidemiology Unit, University of Southampton and professor of musculoskeletal science, University of Oxford in the UK.
Osteoporosis has been recognized throughout antiquity. In the left hand, bottom corner of this slide you see a radiograph of a section of spine removed from a Saxon barrow in the 8th century, and you see quite clearly that there's a vertical compression fracture. Such fractures were reported by Hippocrates more than 400 years before Christ and have been reported throughout antiquity. In the 1820s and 1850s the term osteoporosis was coined to indicate the pathological appearance of bone when it had lost bone volume and bone structure. Sir Astley Cooper documented the most frequent fracture associated with osteoporosis in those days, hip fracture. He showed that it was more common in women than men and he showed that it increased in frequency with age. But our real understanding of osteoporosis stems from research undertaken over the last 75 years, and principally since 1990, when we have developed a uniform definition of osteoporosis based on bone density measurement, developed a number of antiresorptive and formation stimulating therapies against osteoporosis, and developed coherent risk assessment strategies.
The step change for this was the WHO definition of osteoporosis, which is shown in this next slide, that was coined in 1994 and characterized osteoporotic bone density as 2.5 standard deviations or more below the young normal mean. And it was a disorder characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to an increased risk of fracture.