Prevalence and Burden of Osteoporosis in India

Osteoporosis is a disease characterized by micro architectural deterioration of bone and predisposes
to easy fractures. It poses a huge challenge in India, as India is a developing country due to
demographic transition and aging of the population along with limited resource availability in rural
India. Bone health of most Indians is in jeopardy and possess a huge burden to the nation despite
great progress has been made over the last decade in understanding the disease, diagnosis and
treatment.
Worldwide, osteoporosis predominantly affects postmenopausal women, and geriatric population.
Osteoporosis is promptly called a “SILENT DISEASE” as many times the earliest evidence is a
fragility fracture causing hospitalization along with increased morbidity and mortality. The exact
disease burden is difficult to quantify because of the limited data availability along with difficulty in
quantification of magnitude of the problem and the biggest issue is the lack of awareness on the part
of healthcare provider and the public. Unfortunately, it is not possible to measure bone strength or to
detect the architectural deterioration in living patients and most methods are used as “proxies” for
bone strength assessment which are known ad Bone Mass Density (BMD).However, the risk of
fractures can be safely predicted by the World Health Organization (WHO) Fracture Risk Assessment
Tool (FRAX) which is primarily based on clinical risk indicators, with or without the bone density of the
femoral neck. And any patient with a low bone density must be considered for treatment of
osteoporosis (T-score of between −1.0 and −2.5) Bone health is critically important for the quality of
life of individuals. There have been great improvements recently regarding the early prevention,
appropriate assessment, diagnosis and treatment. This chapter will focus on the prevalence of
osteoporosis primarily from the Indian perspective. The Fig. 1 demonstrates the difference between
normal and osteoporotic bone.