New AUS report reveals alarming under-investigation &
under-treatment of osteoporosis in those at risk

Only one in two Australian adults who have broken a bone reported having a bone mineral density test (BMD) to investigate their bone health for the risk of fracture (broken bone), and presence of osteoporosis.
Even more concerningly, of those who have fractured a bone, the vast majority (86 per cent) are not taking preventative osteoporosis medication.

These key findings among others from Healthy Bones Australia’s ‘Know Your Bones Community Risk Report, Second Edition 2021, released today – World Osteoporosis Day (Wednesday, October 20, 2021) – call for earlier investigation and treatment to capture all adults with risk factors for poor bone health, and adults post-fracture.

The new report summarises data from more than 88,000 Australians who have completed Know Your Bones to date – an online self-assessment tool developed by Healthy Bones Australia in partnership with the Garvan Institute of Medical Research, to help Australians understand their potential risk for developing osteoporosis, and bone breaks. The test provides the respondent with personalised recommendations about their bone health, which they can share with their GP for further discussion.

According to Healthy Bones Australia Medical Director and Senior Staff Specialist Rheumatologist at Westmead Hospital, Associate Professor Peter Wong, Sydney, specific risk factors increase a person’s risk for developing osteoporosis, including prior fracture, family history, certain medical conditions or medications, early menopause or low testosterone, lack of calcium or vitamin D, smoking, and high alcohol intake.

“Of the more than 88,000 Australians who have completed the Know Your Bones online self-assessment to date, nearly 40 per cent reported having a clinical risk factor for osteoporosis, while the vast majority (99 per cent) reported having at least one lifestyle risk factor.

“Given more than six million Australians over 50 years of age are living with poor bone health, we are encouraging adults to ‘Know Your Bones’, by completing our online self-assessment, to help curb the more than 183,000 fractures anticipated by 2022,” said A/Prof Wong.

Healthy Bones Australia Chair, Endocrinologist, and Head of the Department of Medicine, School of Clinical Sciences at Monash Health, Professor Peter Ebeling AO, Melbourne, says routine investigation of adults with risk factors for poor bone health is essential to secure an early osteoporosis diagnosis, protecting bone health, and preventing unnecessary fractures.

“Breaking any bone due to poor bone health is a serious medical event. People who fracture from poor bone health have a two-to-four-fold increased risk of breaking another bone. Fractures from poor bone health cause pain and disability, with patients commonly unable to work, drive or complete everyday household tasks.

“Concerningly, our new report reveals one in three Know Your Bones respondents aged over 70 years have not had a BMD test, which is reimbursed by Medicare in this age group. This simple test measures bone density at the hip and  spine to identify poor bone health,” Prof Ebeling said.

“Investigation rates of those with risk factors for poor bone health, or patients who have already broken a bone should be much higher, given this test is widely available and reimbursed.

“Early diagnosis of osteoporosis allows us to prevent unwanted fractures,” said Prof Ebeling.

Consumer advocate, mother-to-three, and grandmother-to-twin girls, Elaine, 57, Melbourne, was finally diagnosed with severe osteoporosis in 2019 after enduring three years of excruciating back pain caused by unidentified spinal fractures. Elaine has an immediate family history of bone disease – her mum was diagnosed with osteoporosis at 70 years of age, while her sister has also experienced fractures.

“Despite my family history of bone disease, it never crossed my mind, nor was it even suggested to me, that I may be at risk for developing osteoporosis, even after going through menopause. 

“Because I had never experienced any falls, no one suspected I was living with bone fractures. So I’m not actually sure how long I had been living with osteoporosis,” said Elaine.

Elaine maintains heightened public awareness of bone health is urgently required to help curb the prevention of painful but unnecessary fractures.

“I encourage everyone to use Know Your Bones and talk to your doctor about your bone health to prevent osteoporosis. The disease has substantially impacted my life, and I want others to avoid the pain I have gone through.”

“Know Your Bones represents a simple first step for Australians to consider their bone health, and can be performed in the comfort of their own homes,” said CEO of Healthy Bones Australia, Mr Greg Lyubomirsky, Sydney.

“Fractures place a huge burden on the cost of the healthcare system and account for the majority (69 per cent) of the expected AUD 3.85 billion, in 2022, including emergency costs, hospital stays, rehabilitation, and community services. We need to educate the community about the risk factors for poor bone health, and ensure adults with risk factors are investigated as part of a routine medical check-up.

“At Healthy Bones Australia, we are committed to improving Australians’ bone health. The data contained in the second edition of the Know Your Bones Community Risk Report provides timely and valuable insights on osteoporosis for health professionals, policy makers, and the community at large,” Mr Lyubomirsky said.

Key ‘Know Your Bones Community Risk Report’ findings

• More than half (52 per cent) of respondents who reported a fracture were aged 50 to 60 years;
• Only half of those who reported a fracture had also had a Bone Density test;
• The majority of respondents (86 per cent) who reported sustaining a fracture said they were not taking preventative osteoporosis medication;
• Nearly 40 per cent of those who completed the Know Your Bones online self-assessment had a clinical risk factor for osteoporosis, while the vast majority of respondents (99 per cent) reported having a lifestyle risk factor for the disease (insufficient calcium intake and vitamin D, lack of exercise, tobacco smoking and alcohol consumption);
• Despite Bone Density testing remaining available, and reimbursed* for anyone over 70 years nearly 30 per cent of respondents said they had not undergone the test.

*Testing is reimbursed for multiple risk factors, including for anyone of any age who has sustained a minimal trauma fracture (from a standing height). 

The Report calls for:

• Early medical intervention to capture adults following a fracture from poor bone health; and
• Routine clinical investigation of adults with risk factors for poor bone health to ensure an early diagnosis of osteoporosis, to protect bone health, and prevent unnecessary fractures.

About osteoporosis

Osteoporosis is a painless disease leading to reduced bone strength and increased risk of fracture.  
Once a fracture occurs, action must be taken to protect bone health, and bone density monitored to gauge improvement. Importantly, osteoporosis and osteopenia affects women and men (who account for up to 30 per cent of all fractures relating to osteoporosis and osteopenia, and their associated costs).

Fractures are expensive to treat and disruptive to the lives of patients, and their families. Data shows sixty-six per cent of Australians aged 50+ are living with poor bone health (osteoporosis or osteopenia). Fractures account for up to 70 per cent of the overall cost of the disease.  

About Healthy Bones Australia

Healthy Bones Australia (formerly Osteoporosis Australia) is a national, not-for-profit organisation that focuses on reducing broken bones and improving bone health across Australia. The organisation was established in 2001 in response to the growing number of Australians living with poor bone health, and the lack of health focus on preventing osteoporosis. Healthy Bones Australia aims to increase community and health professional awareness of osteoporosis, and advocates to government to reduce the impact of the disease, nation-wide.

To learn more, or to take the Know Your Bones online self-assessment, head to knowyourbones.org.au.