Osteoporosis is a skeletal condition characterized by reduced bone volume, bone quality, and increased fragility, leading to an increased risk of fractures.1,2,3 Traditionally, osteoporosis has been diagnosed either by the presence of a fragility fracture or solely on bone mineral density (BMD) in the absence of a fragility fracture. Osteoporosis Canada (OC) now recognizes that although there is a strong association between BMD and the risk of fracture, there are other factors independent of BMD that influence fracture risk in patients such as age and sex. An individual’s fracture risk should be categorized by determining their 10-year absolute fracture risk rather than their BMD alone. The risk assessment systems developed by either the Canadian Association of Radiologists and Osteoporosis Canada (CAROC) or the Canadian WHO Fracture Risk Assessment Tool (FRAX) are recommended for use.4
In Canada, one in three women and one in five men will have at least one fragility fracture attributed to osteoporosis during their lifetime.2,5 A fragility fracture is one that occurs as a result of minimal trauma such as a fall from standing height or less (at no greater than walking speed) or no identifiable trauma. Fractures of the skull, hands, ankles and feet are not considered fragility fractures.6,7
All fragility fractures have serious consequences in terms of morbidity, often leading to increased institutionalization and health care costs.4,5 Mortality is significantly increased following vertebral and hip fractures, with an astounding 28% of women and 37% of men dying within one year following a hip fracture.4,5 While poor outcomes following osteoporotic fractures are well documented, treatment rates for osteoporosis remain low. In 2010 it was estimated that less than 20% of women and 10% of men at risk of osteoporosis were prescribed preventative medications for future fractures.
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