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A recent Australian study has unveiled that implementing simple bone-strengthening measures within the entire community, rather than just targeting those at higher risk, could lead to a significant reduction in hip fractures. Hip fractures, especially among the elderly, substantially increase the risk of death, with approximately 37 percent of men and 20 percent of women succumbing within a year of such fractures. Additionally, they cause considerable pain, loss of mobility and independence, and increased healthcare costs.
Distinguished Professor Tuan Nguyen, a world-renowned osteoporosis researcher from the University of Technology Sydney (UTS) who led this study, emphasizes the importance of people taking steps to enhance their bone health, even if they don’t have osteoporosis, and even if the benefits may seem minor at first glance. He states that while pharmacologic treatments can reduce the risk of hip fractures by about 50 percent in osteoporotic individuals, the majority of hip fractures occur in people without osteoporosis. Thus, it’s vital for everyone, particularly the elderly, to take action to improve their bone health. Bone mineral density is a modifiable factor, and even small enhancements can reduce fracture risks.
Lifestyle factors such as smoking, physical activity, and dietary choices, including vitamin D and calcium intake, significantly impact bone health. Professor Nguyen underscores the importance of quitting smoking, maintaining moderate physical activity, and adopting a healthy diet to mitigate bone loss.
The study, titled ‘Prevention of hip fractures: trade-off between minor benefits to individuals and large benefits to the community,’ was recently published in the Journal of Bone and Mineral Research and involved co-authors from The Garvan Institute of Medical Research and UNSW Sydney. The research drew upon data from the Dubbo Osteoporosis Epidemiology Study, one of the world’s longest-running osteoporosis studies, tracking over 3000 individuals aged 60 and above over time to assess fracture incidence and risk factors.
The researchers discovered that between the initial cohort in 1988-92 and the subsequent one in 1999-2001, there was a 3 percent increase in bone mineral density. Concurrently, there was a remarkable 45 percent decrease in hip fractures, a decrease typically linked to a 10 percent rise in bone mineral density.
This study aligns with the concept put forth by British epidemiologist Geoffrey Rose, suggesting that a population-based measure that offers a small benefit to each individual can yield substantial benefits to the entire community. Professor Nguyen likens this to wearing a car seatbelt, which may provide limited individual benefit due to the low probability of a car accident but collectively saves lives in the community.
In conclusion, even small improvements in bone density, although they might appear inconsequential to individuals, can lead to a significant reduction in the overall fracture risk for the community, as highlighted by this study. Epidemiologist and first author Dr. Thach Tran believes these findings will be of great interest to public health policymakers, medical professionals, and individuals seeking to lower their hip fracture risk. He also suggests that strategies focused on reducing risk in those at low or moderate risk may be more effective than solely targeting high-risk individuals. Furthermore, the study suggests that categorizing bone mineral density into osteoporosis or non-osteoporosis based on an arbitrary threshold may not be the optimal approach for identifying individuals at high risk of fracture.
