Using the current prevalence estimates of osteoporosis based on the NHANES BMD measurements at either the femoral neck or lumbar spine and future US Census projections, the number of people with osteoporosis will increase from an estimated 10.2 million in 2010 to 13.6 million people in 2030, with low bone mass, which may be a precursor to osteoporosis, increasing from 43.4 million people to 57.8 million over the same time frame.1
Although the prevalence of clinically diagnosed osteoporosis is projected to increase further, it is not clear whether the increase reflects an increase in diagnosis or an increase in the actual prevalence of the condition. Specifically, a comparison of femoral neck data from NHANES between 1988 and 1994 and 2005 and 2008 showed an increase in femoral neck BMD and a decline in prevalence of osteoporosis during this time. The observed differences in participant demographics and DXA methods between these NHANES surveys did not completely explain the observed increase in femoral neck BMD. Furthermore, data from NHANES 2005–2010 indicate that both mean femoral neck BMD and total lumbar spine BMD have remained stable during this five-year period among those age 50 years and older.
However, as noted in the introduction to osteoporosis, the diagnosis can also be made based on fragility fracture, which could also play a role in the discrepancy observed between secular trends in the prevalence of clinically diagnosed osteoporosis versus BMD-defined osteoporosis based on femoral neck data from NHANES.2
- 1. Wright NC, Looker AC, Saag KG, et al.: The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. JBMR 2014;29(11):2520- 2526. Doi: 10.1002/jbmr.2269.
- 2. Looker AC, Melton LJ, Borrud LG, Shepherd JA: Changes in femoral neck bone density in US adults between 1988-1994 and 2005-2008: Demographic patterns and possible determinants. Osteoporosis International 2012;23:771-780.