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,