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Improving bone health: addressing the burden through an integrated approach

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Abstract

As people age, maintaining mobility becomes increasingly imperative, therefore addressing bone health is the most important way to preserve mobility. Poor bone health encompasses a broad spectrum of diseases, but it is most often quantified as the cumulative burden of osteoporosis and osteoporotic fractures. Rates of these fractures have been increasing and are expected to continue rising globally, attributed to increasing life expectancy worldwide. No single strategy will be sufficient to address this global public health issue. Co-ordination across a wide array of stakeholders is vital to decrease the health and socioeconomic burden of poor bone health. Stakeholders include an assortment of specialists ranging from health professionals (primary and secondary care clinicians, nurses, physical therapists, and social care workers), policy-makers, government bodies (including departments of health and social services), employers, civil society, as well as patients and their caregivers.  We need to ensure that there is a better understanding of the socioeconomic and health consequences of poor bone health to promote better policies to address needs. Building a more resilient health system approach to bone health based on the evidence and sound decision-making will not only improve population health, but will provide cost savings to health systems by preventing poor bone health in the first place. Health systems around the world must prioritise bone health to preserve mobility and wellbeing in advance of the impending surge in demand from ageing populations. Poor bone health is not an inevitable part of ageing. Working across the lifespan, we can all benefit from improved bone health throughout our lives.

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Acknowledgements

We are indebted to our Expert Panel for their contributions, insights and time they generously shared with us. The Expert Panel members were: Professor Robert Blank, Professor Emeritus of Medicine, Medical College of Wisconsin; Visiting Scientist, Garvan Institute of Medical Research, Australia; Professor Cyrus Cooper, OBE, Professor of Rheumatology and Director of the MRC Life Course Epidemiology Unit, Vice-Dean of the Faculty of Medicine at the University of Southampton, Professor of Epidemiology at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, UK; Professor Michael Graven, Retired faculty from Dalhousie University, Former Director, Medical Informatics, USA; Dr Samuel Hailu, Orthopaedic Trauma and Arthroplasty Surgeon, Addis Ababa University, Tikur Anbessa (Black Lion) Specialized Hospital, Ethiopia; Dr Phillippe Halbout, Chief Executive Officer, International Osteoporosis Foundation, Switzerland; Ms Teréza Hough, Chief Executive Officer, National Osteoporosis Foundation of South Africa; Dr Andréa Marques, Rheumatology Department, Centro Hospitalar e Universitario de Coimbra; Nursing, Health Sciences Research Unit, Portugal; Professor Eugene McCloskey, Professor, Adult Bone Diseases, Director of the MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing, Healthy Lifespan Institute, Mellanby Centre for Musculoskeletal Research, Department of Oncology and Metabolism, University of Sheffield, UK; Professor Rosa Maria Pereira, Department of Rheumatology, Hospital das Clinicas HCFMUSP, Professor at the Faculty of Medicine of the University of Sao Paulo, Brazil; Ms Lisa Qualls, Director of Partner Relations, American Bone Health, USA; Professor Jean-Yves Reginster, MD, PhD, University of Liege, Belgium, King Saud University; Dr Kanwaljit Soin, Orthopaedic and Hand Surgeon, Former Nominated Member of Parliament of Singapore, Founding President of Women’s Initiative for Ageing Successfully, Author of ‘Silver Shades of Grey: Memos for Successful Ageing In the 21st Century’, Singapore; Dr Maria Belen Zanchetta, Medical and Academic Director, IDIM, Director, Postgraduation Chair in Osteology and Mineral Metabolism at Salvador’s University, Member, ASBMR Membership Engagement Committee; Ambassador, LATAM ASBMR, Regional Advisory Committee, International Osteoporosis Foundation, Argentina. We are grateful for the input we received from the specialists we interviewed: Dr Gemma Adib, Founder and President, Syrian National Osteoporosis Society, Board member, International Osteoporosis Foundation Regional, Advisory Committee Chair, RAC; Pan Arab Osteoporosis Society GS (PAOS); Professor Paul Anderson, Professor, Department of Orthopedics Surgery and Rehabilitation, University of Wisconsin; Dr Bruno Boietti, Medical Professional, Hospital Italiano of Buenos Aires, Consultant, Ministry of Health, Argentina; Professor Matthew Costa, Professor of Orthopaedic Trauma, University of Oxford, Honorary Consultant Trauma Surgeon, John Radcliffe Hospital; Professor Juliet Compston, Professor Emeritus of Bone Medicine, Cambridge Biomedical Campus; Dr Greg Lyubomirsky, CEO, Osteoporosis Australia; Dr Jay Magaziner, Chair, Department of Epidemiology and Public Health, Director, Center For Research on Aging, University of Maryland; Dr Polyzois Makras, Consultant Endocrinologist, Department of Endocrinology and Diabetes, Head of the Department of Medical Research, 251 Hellenic Air Force and VA General Hospital; Dr Paul Mitchell, Founder, Synthesis Medical Limited; Professor Sonia Cerdas Pérez, Professor of Endocrinology, University of Costa Rica, Endocrinologist, Hospital CIMA, Founder, Costa Rican Menopause and Osteoporosis Society; Professor Leith Zakraoui, Professor of Rheumatology, University of Tunis School of Medicine, Head of the Department of Rheumatology, Hospital Mongi Slim La Marsa, Founder, Tunisian Osteoporosis Prevention Society (TOPS). We extend a special thanks to our expert consultant, Professor Liesbeth Borgermans, Professor of Primary Care, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, University of Ghent, Belgium, for her guidance and views.

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The research was sponsored by Amgen.

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    Mary E. Bussell

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This research was conducted by The Economist Intelligence Unit Health Policy team from 2020 to 2021. The Economist Intelligence Unit bears sole responsibility for the content of this report. The findings and views expressed in the report do not necessarily reflect the views of the sponsor. The research was led by Dr Mary Bussell with input from The Economist Intelligence Unit team consisting of Taylor Puhl, Amanda Stucke, Marcela Casaca, Giulia Garcia, Lorena Perez and Janet Clapton.

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Correspondence to Mary E. Bussell.

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Bussell, M.E. Improving bone health: addressing the burden through an integrated approach. Aging Clin Exp Res 33, 2777–2786 (2021). https://doi.org/10.1007/s40520-021-01971-3

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