Our findings suggest that although pregnancy and lactation are periods of physiological calcium loss, higher parity is not associated with an increased risk of postmenopausal osteoporosis; rather, it appears to confer a long-term protective effect. Osteoporosis is a significant public health burden. While parity induces transient bone loss, their long-term skeletal impact remains poorly understood. This study aimed to clarify the associations between parity, defined as the number of live births, and the risk of osteoporosis, osteoporotic fractures, and bone mineral density (BMD). We analyzed data from 119,969 women in the UK Biobank. Associations between parity and incident osteoporosis or fractures were evaluated using unweighted and inverse probability of treatment weighting Cox proportional hazards models. Generalized linear models assessed associations with femoral neck and lumbar spine BMD. Models were adjusted for sociodemographic, genetic, lifestyle, and clinical factors. Compared with nulliparous women, those with a parity of 2 or 3 exhibited a significantly reduced risk of osteoporosis in the weighted fully adjusted model. In addition, parity of 3 exhibited a significantly reduced risk of osteoporotic fracture compared with the nulliparous group. This protection was evident in women ≥ 60 years and those with normal body mass index. Parity was not significantly associated with areal BMD changes after full covariate adjustment. In women aged 40–69 years at baseline, a parity of 2 or 3 confers long-term protection against osteoporosis and osteoporotic fracture (a arity of 3), occurring independently of BMD changes. These findings support the integration of parity into clinical risk assessment tools, ultimately contributing to more effective osteoporosis prevention and a reduced fracture burden across women’s lifespan.
The 2021 UK Chief Medical Officers' annual report highlighted poorer health in coastal communities but did not include osteoporosis or secondary fracture prevention. Using Fracture Liaison Services database (FLS-DB) data, FLSs in coastal areas were shown to have poorer performance and lower parenteral osteoporosis medication recommendation rates, supporting inclusion of FLSs in coastal health improvement plans. A number of studies have highlighted socio-economic deprivation as a predictor of fragility fractures and poorer outcomes after fracture. In parallel, coastal areas are recognised to be areas with poorer health outcomes, in part due to socio-economic deprivation. To describe secondary fracture prevention in terms of FLS provision and quality in coastal vs. non-coastal healthcare settings using routinely collected audit data. A cross-sectional, ecological analysis using the missed opportunity counts from the national Fracture Liaison Service (FLS-DB) and Hip Fracture (NHFD) Databases of England and Wales audit data with Office for National Statistics classification of coastal towns. Results Coastal sites were not significantly more likely to be non-FLS vs FLS providers (38
Hospitalisations for vertebral fractures increased in Germany over the past two decades. Although hospitalisation rates have recently stabilised or declined, demographic projections indicate that the absolute inpatient hospitalisation burden may remain substantial through 2050. These findings highlight the need for better osteoporosis prevention and long-term healthcare planning. Vertebral fractures represent one of the most common manifestations of skeletal fragility and contribute substantially to morbidity, disability, and healthcare utilisation in ageing populations. However, nationwide long-term hospitalisation trends and the impact of demographic ageing on future inpatient burden remain insufficiently characterised. This study investigated inpatient hospitalisation trends for vertebral fractures and postmenopausal osteoporosis in Germany over a 24-year period and estimated the future inpatient burden through 2050. Nationwide inpatient data from the German Federal Health Monitoring (GBE) database were analysed between 2000 and 2023. Hospitalisations were identified using ICD-10-GM codes for thoracic vertebral fractures (S22.0), lumbar vertebral fractures (S32.0), and postmenopausal osteoporosis with osteoporotic fracture (M80.0). Absolute hospitalisations, age-standardised hospitalisation rates, sex-specific trends, in-hospital mortality, and length of hospital stay were evaluated. Temporal trends were assessed using joinpoint regression. Future hospitalisations were projected by applying age-specific hospitalisation rates observed during 2021–2023 to the official German population projections (Destatis main scenario G2L2W2). Between 2000 and 2023, annual hospitalisations increased from 14,057 to 27,563 for thoracic vertebral fractures, from 27,683 to 45,280 for lumbar vertebral fractures, and from 2,617 to 11,800 for postmenopausal osteoporosis with osteoporotic fracture. In contrast, age-standardised hospitalisation rates increased until the mid-to-late 2010s before stabilising or declining across all three diagnoses. Joinpoint regression identified significant trend reversals for thoracic vertebral fractures (2016), lumbar vertebral fractures (2018), and postmenopausal osteoporosis with osteoporotic fracture (2015). Overall, lumbar vertebral fractures (AAPC − 0.65
This study used a microsimulation model to assess the impact of improved osteoporosis diagnosis, treatment, and adherence in Taiwan. The combined approach prevented 42,605 fractures and saved NT4.64 billion by 2045. The results emphasize the importance of comprehensive anti-osteoporosis management in evidence-based healthcare policy. Taiwan’s rapidly aging population presents mounting challenges for osteoporosis management, with healthcare resources increasingly constrained under the National Health Insurance system. This study projected the clinical and economic impact of enhanced osteoporosis diagnosis, treatment, and adherence strategies among postmenopausal women in Taiwan from 2025 to 2045. A cross-sectional microsimulation model projected annual osteoporotic fracture incidence and costs among postmenopausal women aged ≥65 years. Fracture risk was estimated using simplified Fracture Risk Assessment Tool (FRAX), with inputs from published literature and national health insurance data informing demographic distribution, treatment patterns, and healthcare costs. Three scenarios evaluated: (1) improved medication adherence alone, (2) increased case finding through enhanced screening and treatment rates, and (3) combined case finding and adherence improvements. In the reference scenario, the annual number of osteoporotic fractures are projected to increase by 99
This study examined why many older adults in Iran with osteoporosis are not diagnosed or treated. It found very high rates of missed diagnosis and lack of treatment, especially influenced by age, gender, and education. Addressing these gaps is essential to improve awareness, care access, and prevent serious bone-related health problems. Despite the availability of diagnostic and therapeutic facilities for osteoporosis, a significant proportion of older adults remain undiagnosed and untreated. This care gap may stem from various barriers and understanding the underlying reasons for these disparities is crucial for developing targeted interventions. This study aimed to investigate the gaps in osteoporosis diagnosis and treatment among older adults in Iran and to identify the key factors contributing to these gaps. This cross-sectional study analyzed data from two phases of the Bushehr Elderly Health (BEH) Program. Participants were selected using multistage cluster random sampling. The first phase, conducted between 2015 and 2017, included 2424 residents aged 60 and above. The second phase, from 2018 to 2021, involved 1721 residents aged 50 and above. Bone mineral density (BMD) was measured using the Dual-energy X-ray absorptiometry method and T-score ≤ –2.5 in either of the femoral neck, total hip, or spinal sites was defined as osteoporosis. Participants reported whether a doctor had diagnosed them with osteoporosis and if they received treatment. Those diagnosed via bone densitometry but unaware of their condition were considered underdiagnosed. Those diagnosed through BMD tests but not on osteoporosis medication were considered undertreated. Multiple logistic regression was used to identify determinant factors of the underdiagnosis and undertreatment of osteoporosis. A total of 4145 elder adults with a mean age of 65.5 (54.40
