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Table 6 Description of studies on osteoporosis (OP)

From: What is the prevalence of musculoskeletal problems in the elderly population in developed countries? A systematic critical literature review

 

First author Publ. year Country

Study design / Population /Method of collection

Sample size

Crude response rate (%)

Outcome definition

Outcome assessment method

Prevalence period

Age

Prevalence* (95% CI)

Risk of bias

   

Total

M

F

     

M

F

Total

 

Lumbar spine or hip

Andrianakos [41] 2006 Greece

1966-99, (19+ yo), the total population in 7 mixed communities + random sample in another 2 mixed communities. Examination (rheumatological centers)

8740

4269

4471

82

WHO BMD T-score −2.5 SD or less

DXA

Point

59-64

  

7

L

69+

10

Lumbar spine or hip

Bleicher [43] 2010 Australia

2005-07, (70+ yo), community-dwelling in three local government areas around Sydney (CHAMP). Questionnaire + Examination

1626

1626

0

45

Pharmaceutical Benefits Scheme criteria for OP: BMD T-score −3 SD or less

Hologic DXA

Point

70-74

  

5.0

U

75-79

4.0

80-84

5.0

85-89

5.0

90+

14.0

Lumbar spine or hip

Naves [48] 2005 Spain

(50+ yo), randomly selected from the Oviedo municipal register. Postal questionnaire + examination

229

229

0

74

The Int. Society of Clinical Densitometry: BMD with a T-score −2.5 SD or less

Hologic DXA, QDR 1000 densitometer

Point

80+

12.5

  

U

Lumbar spine or hip

Sanfélix-Genovés [49] 2010 Spain

2006-7, (50+ yo), stratified random sample of women included in the Population Information System of the Valencia Healthcare Agency, Valencia (the FRAVO Study). Interview, questionnaire + examination

824

0

824

47

WHO BMD T-score −2.5 SD or less

Norland & Hologic densitometer

Point

60-64

 

22.5 (16.3-28.8)

 

U

65-69

32.4 (25.2-39.4)

70-74

39.9 (31.8-47.9)

75+

49.3 (37.4-61.2)

Lumbar spine or hip

Vestergaard [52] 2005 Denmark

1995-9, all in- and outpatients recorded in The National Hospital Discharge Register (=100%) based on all ICD-10 codes on OP. National register

11359

1426

9933

N/A

WHO BMD T-score −2.5 SD or less

The National Hospital Discharge Register

Point

60-64

14.7

 

29.6

L

65-69

19.9

44.0

70-74

26.1

59.1

75-79

33.1

72.2

80-84

40.4

81.3

85-89

47.8

85.8

90-94

55.3

88.6

95+

64.3

92.3

Lumbar spine

Cui [44] 2008 South Korea

2004-5, (20–79 yo), from the Namwon study and the Thyroid Disease Prevalence study and from two provinces. Interview + questionnaire + clinical examination

4148

1810

2338

39

WHO BMD T-score −2.5 SD or less

Lunar DXA

Point

60-69

8.7

51.3

 

U

70-79

12.8

60.2

Lumbar spine

Henry [45] 2000 Australia

1997, (20–94 yo), age-stratified, random, population-based sample of women registered (compulsory) in the Commonwealth of Australia Electoral Rolls, Geelong. Questionnaire + examination.

1494

0

1494

63

WHO BMD T-score −2.5 SD or less

Lunar DXA, DPX-L densitometer

Point

60-64

 

10.5

 

U

65-69

15.2

70-79

28.8

80+

 

Lumbar spine

Sanfélix-Genovés [49] 2010 Spain

2006-7, (50+ yo), stratified random sample of women included in the Population Information System of the Valencia Healthcare Agency, Valencia (the FRAVO Study). Interview, questionnaire + examination

824

0

824

47

WHO BMD T-score −2.5 SD or less

Norland & Hologic densitometer

Point

60-64

 

18.5 (12.7-24.3)

 

U

65-69

 

28.2 (21.4-35.0)

 

70-74

 

37.8 (28.8-45.7)

 

75+

 

39.1 (27.5-50.7)

 

Lumbar spine

Shin [50] 2010 South Korea

2006-7, (40+ yo), selected group from the 2001 cohort of residents in the farming community of Ansung through mailing, door-to-door and telehpone solicitations (the Korean Health and Genome Study, KHGS). Examination

3538

1547

1991

71

WHO BMD T-score −2.5 SD or less

Lunar Prodigy DXA

Point

60-69

13.7

28.5

 

U

70-79

22.4

47.5

Lumbar spine

Vestergaard [52] 2005 Denmark

1995-9, all in- and outpatients recorded in The National Hospital Discharge Register (=100%) based on all ICD-10 codes on OP. Register (National)

11359

1426

9933

N/A

WHO BMD T-score −2.5 SD or less

The National Hospital Discharge Register

Point

60-64

3.4

 

17.3

L

65-69

4.6

27.7

70-74

6.0

39.6

75-79

7.9

51.1

80-84

10.1

60.2

85-89

12.7

66.0

90-94

15.8

68.2

95+

19.8

65.6

Lumbar spine

Yang [51] 2004 Taiwan

1994-8, female patients entering a hospital for a DXA scan. Examination (hospital)

4689

0

4689

?

Threshold level, lumbar spine < 0.827 g/cm2

Lunar DXA

Point

60-69

 

14.1

 

H

70-79

14.3

80+

16.1

Lumbar spine

Yoshimura [35] 2009 Japan

1990, (40–79 yo), all inhabitants from the register of residents in Miyama village (the Miyama Study). Examination

400

200

200

100

WHO BMD T-score −2.5 SD or less

Lunar DXA

Point

60-69

12.0

38.0

 

U

70-79

14.0

60.0

Lumbar spine

Yoshimura [33] 2009 Japan

2005-7, (40+ yo), recruited from the resident-registration lists of the Hidakagawa & Taiji regions or from a randomly selected cohort study from the Itabashi (Tokyo) Ward resident registration database (the ROAD study). Examination

3040

1061

1979

76

Criteria of the Japanese Society of Bone and Mineral Research (BMD <70% of PBM: lumbar spine BMD < 0.708 g/cm2)

Hologic DXA

Point

60-69

2.6

13.5

 

U

70-79

3.6

29.8

80+

7.4

43.8

Hip

Vestergaard [52] 2005 Denmark

1995-9, all in- and outpatients recorded in The National Hospital Discharge Register (=100%) based on all ICD-10 codes on OP. National register

11359

1426

9933

N/A

WHO BMD T-score −2.5 SD or less

The National Hospital Discharge Register

Point

60-64

12.7

20.0

 

L

65-69

17.7

30.4

70-74

23.7

42.5

75-79

30.8

54.6

80-84

38.6

65.4

85-89

46.9

73.9

90-94

55.3

79.9

95+

64.3

83.9

Femoral neck

Cui [44] 2008 South Korea

2004-5, (20–79 yo), from the Namwon study and the Thyroid Disease Prevalence study invited to clinical examination and interview, from two provinces. Interview, questionnaire + examination

4148

1810

2338

39

WHO BMD T-score −2.5 SD or less

Lunar DXA

Point

60-69

7.3

11.4

 

U

70-79

15.2

36.7

Femoral neck

Henry [45] 2000 Australia

1997, (20–94 yo), age-stratified, random, population-based sample of women registered (compulsory) in the Commonwealth of Australia Electoral Rolls, Geelong. Questionnaire + examination

1494

0

1494

63

WHO BMD T-score −2.5 SD (NB. Hip: femoral neck used in this review)

Lunar DXA, DPX-L densitometer

Point

60-64

 

15.2

 

U

65-69

20.8

70-79

31.6

80+

36.5

Femoral neck

Holt [46] 2002 UK

(50+ yo), random sample from seven health centres (Aberdeen, Bath, rural Cambridgeshire, Harrow, Truro, Norfolk, and Cambridge City). Questionnaire + examination

7426

2253

5173

48

WHO BMD T-score −2.5 SD (NB. Hip: femoral neck used in this review)

Hologic DXA, QDR 1000 densitometer

Point

65+

2.7

8.1

 

U

Femoral neck

Sanfélix-Genovés [49] 2010 Spain

2006-7, (50+ yo), stratified random sample of women included in the Population Information System of the Valencia Healthcare Agency, Valencia (the FRAVO Study). Interview, questionnaire + examination

824

0

824

47

WHO BMD T-score −2.5 SD or less

Norland & Hologic Densitometer.

Point

60-64

6.9 (3.1-10.7)

  

U

65-69

10.1 (9.4-21.3)

70-74

15.4 (9.4-21.3)

75+

34.8 (23.4-46.1)

Femoral neck

Yang [51] 2004 Taiwan

1994-8, female patients entering a hospital for a DXA scan. Examination (hospital)

4689

0

4689

?

Threshold level, femoral neck < 0.605 g/cm2.

Lunar DXA

Point

60-69

 

11.2

 

H

70-79

17.3

 

80+

24.0

 

Femoral neck

Yoshimura [33] 2009 Japan

2005-7, (40+ yo), recruited from the resident-registration lists of the Hidakagawa & Taiji regions or from a randomly selected cohort study from the Itabashi (Tokyo) Ward resident registration database (the ROAD study). Examination

3040

1061

1979

76

Criteria of the Japanese Society of Bone and Mineral Research (BMD <70% of PBM): femoral neck < 0604 g/cm2 (men) & < 0.55 g/cm2 (women)

Hologic DXA

Point

60-69

7.0

22.2

 

U

70-79

22.3

42.9

80+

13.0

65.1

Phalanges

Biino [42] 2011 Italy

2003-2008, (30–103 yo), all residents from 10 villages of the Ogliastra region, Sardinia. Interview + examination

6326

2024

4302

51

AD-SoS T-score −3.2 SD or less

Quantitative II-V phalanges ultrasound

Point

60-69

9.6

24.2

 

U

70-79

13.6

42.7

80+

25.8

62.1

Heel

Kenny [47] 2009 USA

Community-dwelling and assisted living adults recruited through community talks. Questionnaire + examination

114

81

33

?

BMD T-score level not stated

Lunar QUS, Quantitative heel Ultrasound

Point

82.4 ± 4.6

  

31.6

H

Other

Cheng [53] 2009 USA

1999-2005, (65+ yo), a 5% national sample from beneficiaries fee-for service Medicare parts A and B coverage, not enrolled in a health maintenance organisation. Register (Medicare)

911327

359733

551594

N/A

Beneficiaries with at least one claim for certain OP related services and with ICD code for OP or fractures associated with OP

ICD-9 code for OP

Point

65-69

  

2.0

U

70-74

17.2

75-79

25.5

80+

55.4

Other

Collerton [12] 2009 UK

2006-7, (85+ yo), all people born in 1921, permanently registered with a participating GP in Newcastle upon Tyne or North Tyneside primary care trusts (the Newcastle 85+ Study). Register (GP)

853

323

530

59

Not stated

Medical record

Point

85

3.8

20.0

14.2

U

Other

Kotz [54] 2004 USA

1994 + 1995, (16–94 yo at baseline in 1965), responders who have survived until at least 1994, from the random representative sample of women from the Alameda County Study, California. Postal questionnaire

1171

0

1171

97

Ever had osteoporosis?

Self report

Life time

66-75

 

11.5

 

H

76-94

18.7

Other

Lespessailles [55] 2009 France

2006, (45+ yo), stratified random sample of women from the national population data (INSEE) (the INSTANT study). Interview + questionnaire (door to door)

2613

0

2613

N/A

Whether they had osteoporosis + whether this had been diagnosed by bone densitometry

Self report

Life time

60-64

 

10

 

U

65-69

14

70-74

17

75-79

16

80-84

15

85+

10

Other.

Picavet [18] 2003 The Netherlands

1998, (25+ yo), a 6 months follow-up on a baseline stratified random sample taken from the population register (the DMC3-study). Postal questionnaire

2338

?

?

85

"Please indicate whether a physician or medical specialist has ever told you that you have one or more of the following diseases [OP]”

Self report

Life time

65-74

  

13

H

75+

15

Other.

Saks [56] 2001 Estonia

2000, (65+ yo), a stratified random sample of patients from 200 random GPs in 16 Estonian regions. Register (GP).

811

391

420

81

GP diagnosis without any further description or validation

Medical record

Point

65-84

  

15.2

U

85+

19.5

Other

Werner [57] 2003 Israel

1997-8, (60+ yo), a stratified random sample of Jewish and Arab community-dwelling persons from the Central Bureau of Statistics (the Israeli Survey of Elderly Persons Aged 60 and Over Study). Interview + questionnaire (home visit)

3022

1688

1334

60

Whether a physician had ever diagnosed them as having osteoporosis

Self report

Life time

60-69

5.0

20.5

 

U

70-79

8.0

26.3

          

80+

7.9

28.3

  
  1. *Prevalence estimates without decimals are obtained from figures/graphs in the article and should be interpreted with caution.
  2. R: Register. L: Low, U: Unclear, H: High.
  3. BMD: Bone mineral density; WHO: World Health Organization, GP: general practitioner, DXA: Dual X-ray absorptometry.