Hospitalizations involving an injury likely due to osteoporosis climbed 55 percent from 1995 to 2006, according to a report released in July by the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality.

 

But according to Stavros Manolagas, MD, PhD, a leading researcher at UAMS, progress is being made in the fight against the disease.

 

The AHRQ report found the number of injury-related hospitalizations rose abruptly from 55 hospitalizations per 100,000 Americans in 1995 to 64 the following year and continued on a steady ascent until 2005, when it hit 86. In 2006, it dropped slightly to 85.

 

More than 250,000 osteoporosis sufferers were admitted to hospitals as a result of injuries in 2006. According to the Arkansas Department of Health, statewide there were 8,691 such diagnoses in 2007. Pathological fractures and fractures of the hip, vertebrae, ribs and pelvis were the most frequently occurring injuries nationwide.

 

Not surprisingly, most injury-related hospitalizations involved elderly women. Females accounted for nearly 89 percent of the stays. Almost 90 percent involved patients 65 years and older, while 37 percent were 85 and older. The U.S. Preventive Services Task Force recommends routine screenings of women ages 65 and over, with women at greater risk for fractures recommended to begin the screenings at age 60.

 

According to Anne Elixhauser, AHRQ senior research scientist, the numbers were gathered from 40 statewide organizations, with the totals for the other states extrapolated from those findings. She said in a phone interview that AHRQ did not attempt to examine why the number of hospitalizations for osteoporosis-related injuries had increased so rapidly.

 

Manolagas offered a number of explanations. A Greek endocrinologist who wrote his dissertation on the effects of steroids on bone and osteoporosis in England in 1979, Manolagas has spent his career studying the disease. He came to UAMS 17 years ago to establish and direct the Osteoporosis and Metabolic Bone Diseases Center, a leading institution researching the disease.

 

Manolagas said that, naturally, an aging population is resulting in increased problems associated with osteoporosis, but he said there are other factors involved. More diagnoses are occurring because the healthcare industry and patients are simply more aware of osteoporosis, and physicians are becoming better at detecting it. Excessive medical use of steroids also increases the disease's incidence. Lifestyle changes are also contributing to the rise, including consumption of soda pops, which block the absorption of calcium. Meanwhile, he said more Americans are suffering from vitamin D deficiency because they are trying to avoid direct sunlight.

 

Finally, Manolagas said treatment protocols have been in a state of transition since once-popular hormone replacement therapies were found to cause cancer and heart disease. Drugs that came along in their place were effective but difficult for many women to tolerate.

 

But he said new treatment options are showing a lot of promise. He said drugs such as Reclast, which can be taken once a year through an infusion, are very effective. Moreover, he said vaccines taken once or twice a year after menopause are "around the corner" while anabolics such as Teriparatide will for the first time be able to rebuild bone.

 

"I think we have made remarkable advancements in the treatment of osteoporosis," he said. "From having nothing other than estrogen 20-25 years ago, we now have treatments as simple as a 15-minute infusion once a year. We have been applying these medications here at UAMS for a long, long time (with) very, very remarkable success."

 

Those treatments will become more important to society as the population, including Baby Boomers born between 1946 and 1964, continues to age. About 10 million Americans suffered from the disease in 2006, and the cost of treating hospitalizations due to injuries was $2.4 billion. According to the Federal Interagency Forum on Aging-Related Statistics, there were 37 million Americans age 65 and over that year – 12.5 percent of the population. By 2030, that number will double to 71.5 million, or 20 percent of the population.