Osteoporosis is the most common underlying cause of fractures in the elderly, but it is not frequently diagnosed or treated, even in individuals who have already suffered a fracture. Ten million Americans have osteoporosis, while another 34 million have low bone mass and are at risk for developing osteoporosis. Eighty percent of those affected are women. By 2020, one in two Americans over age 50 will be at risk for osteoporosis and low bone mass.

Each year about 1.5 million people suffer a bone fracture related to osteoporosis, with the most common breaks in the wrist, spine, and hip. One in five individuals who fracture a hip die within a year of the fracture and about one in five individuals with a hip fracture end up in a nursing home within a year. The direct care costs for osteoporotic fractures alone are up to $18 billion each year.1

Osteoporosis may be prevented and treated by getting the recommended amounts of calcium, vitamin D, and physical activity, and by taking prescription medication when appropriate. Bone density tests are recommended for all women over 65 and for any man or woman who suffers even a minor fracture after age 50. Treatment of osteoporosis has been shown to reduce the risk of subsequent fractures by 30-65 percent.1

National data in 2003 indicate that only 18 percent of female Medicare beneficiaries 67 years of age or older who had a fracture received either a bone mineral density test or a prescription. Most plans were in the range of 10 to 26 percent. Based on voluntary reporting of a subset of plans, it is estimated that about 10 percent of women received only a prescription and about 8 percent of women received only the test. Only about 3 percent of women aged 67 or older received both the bone mineral density test and a prescription. This is considered the highest standard of care.

HEIDS Measure of Osteoporosis Management in Women Who Had a Fracture Medicare Plans 2003[d]

1 U.S. Department of Health and Human Services. Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General, 2004.