Revista de Medicina Desportiva (English) January 2019 | Page 14
Rev. Medicina Desportiva informa, 2019; 10(1):12-20.
Summary of the speeches
presented at the Health Fair of
Porto Marathon
Dr. Basil Ribeiro
Sports Medicine.
Clínica Médica da Foz.
Runporto.
Some numbers of the osteoporosis
According to the Portuguese Society
of Rheumatology (PSDR), osteopo-
rosis is a disease characterized by
the diminution of the mineral bone
density and also by changes on the
quality of the bone. These changes
lead to a greater bone fragility,
where small impacts are enough
to cause a fracture, where the hip,
vertebral bodies (especially low back
and the last thoracic) and on the
wrist are more frequent.
It is estimated that if affects about
200 million women in the world, and
it occurs in about 1/10 women with
60 years of age, but a lot more fre-
quent on women on the nineties. On
theses ages, 2 out of 3 women have
osteoporosis. It affects more than 75
million people in Europe, USA and
Japan. According to European data,
12 january 2019 www.revdesportiva.pt
in 2011, the estimation of persons
with osteoporosis in Europe was 22
millions of women and 5.5 millions
of men, of which 3.5 millions had
suffered a fragility fracture per year.
In Portugal, between the period of
2011-2013, on people older than 18
years, the estimated prevalence was
equal to 10.2%, where 17% were
women and 2,6% were men.
The most dramatic consequence
of osteoporosis is bone fracture and
the number of insufficiency fractu-
res keeps on growing year after year.
An update of the Portuguese Society
of Rheumatology, published on
2018, indicates an estimation of 40
thousand osteoporotic fractures per
year in Portugal, that included 10
thousand hip fractures (2018), a very
superior number comparing to the
year of 1989 (5600), but similar to
the values of 2011 (10124). At world
level, between 1990 and 2000, there
was an increase of the hip fractures
of almost 25%, being the period of
life between 75 and 79 years of age
where they occurred most and for
both sexes.
At world level, the estimation for
the year 2000 was the occurrence
of 9 millions of fractures, with the
contribution of Europe and Ame-
rica of 51% of the total, with wrist
fractures (1.7 millions), hip fractures
(1.6 million) and back (1.4 millions).
In general, and in all over the world,
on people older than 50 years of age,
the risk fracture is 1 out of 3 women
and 1 out of 5 men. The longevity
increase and some sedentarism will
worsen the problem and it is esti-
mated that on the year of 2050, in
relation to the year of 1990, the inci-
dence of hip fractures will increase
310% in men and 240% in women!
The fragility fracture has costs.
Right from the beginning it com-
promises the quality of life of the
patients, causing limitation on their
independence, increasing the mor-
bidity (more infections, for example)
and the mortality. Related to the last
one, it should be stressed out that
the hip fractures are associated to
an excess of mortality equal to 12%
on the first year, that it is prolonged
during the coming years. And do not
think that this fatality applies only
to older women, since a 50-year-old
woman has a risk of dead of 2.8%
related to hip fracture during the
rest of her life. It is estimated that
in Europe, on the year of 2010, it has
been lost 26300 years of life due to
osteoporotic fractures (!). In Spain,
13% of the patients that had had a
hip fracture died after three months
and 38% will die after two years.
There will be an overload for the
family and for the caregivers, so
many times forcing the institutiona-
lization of the patient and to look for
additional medical care and phy-
siotherapy. It is said that after a hip
fracture, between 10 a 20% of people
that were previously independent,
will need continued long-lasting
care. The literature refers that “the
incapacity caused by osteoporosis
is greater than the one caused by
cancer (except lung cancer) and is
comparable or bigger in relation to
other diseases: rheumatoid arthritis,
asthma and heart disease related
to high blood pressure”. Scary, no
doubt.
Then, the financial cost that,
although the patient is not ware of,
is very high. The accounting rela-
ted to the year of 2011, in Portugal,