Fracture Burden: What Two and a Half Decades of Dubbo Osteoporosis Epidemiology Study Data Reveal About Clinical Outcomes of Osteoporosis

Purpose of the Review This review aims to highlight important clinical findings from the over 25 year-long Dubbo Osteoporosis Epidemiology Study particularly focusing on outcomes post fracture. Recent Findings Every low trauma fracture in the elderly is associated with an increased risk of a subsequent fracture, with a higher risk in men than women. All major or proximal fractures and even minor fractures in the very elderly or minor fractures that are then followed by re-fracture are associated with premature mortality, greatest in the first 5 years post fracture. Having a subsequent fracture further increases this high mortality risk, but if an individual survives the high risk period, their risk returns to that of the background population. Non-hip non-vertebral fractures account for a significant proportion of the premature mortality. Despite an improvement in overall health and population mortality over the years, excess mortality post fracture has not changed in the last 2 decades. Summary All low trauma, fractures in the elderly herald a high risk of poor outcomes, particularly in the first few years post fracture. Early intervention should be initiated.