Bone fractures and feeling at risk for osteoporosis among women in Japan: patient characteristics and outcomes in the National Health and Wellness Survey

SUMMARY: Women aged 50 and older in Japan were compared according to perceived risk for osteoporosis and fracture history. Perceived risk was associated with family history of osteoporosis but few other risk factors. Few felt at risk, and perception was only loosely related to epidemiological risks, indicating a need for patient education. PURPOSE: Osteoporosis is prevalent but underdiagnosed and undertreated. This study was conducted to explore characteristics associated with history of fractures and feeling at risk for osteoporosis in women aged 50 and older in Japan. METHODS: Data were provided by a large annual survey representative of Japanese aged 18 and older. Women 50 and older without diagnosed osteoporosis were categorized into four mutually exclusive groups based on fracture history since age 50 and feeling at risk for developing osteoporosis. Sociodemographic and health characteristics were compared across groups using bivariate statistics, and health outcomes were compared using generalized linear models. RESULTS: A total of 16,801 women aged 50 and older were included in the analyses. Most (n = 12,798; 76.2 %) had no fracture since age 50 and did not feel at risk for osteoporosis, 12.9 % (n = 2170) felt at risk but had no fracture, 8.7 % (n = 1455) did not feel at risk despite having a fracture, and 2.2 % (n = 378) had a fracture and felt at risk for osteoporosis. Feeling at risk was slightly more common among those with than without a fracture since age 50 (20.6 vs. 14.5 %, p < 0.001). Feeling at risk was most associated with family history of osteoporosis, though known risk factors for fracture did not significantly differ across the fracture/perceived-risk group. CONCLUSIONS: Approximately 15 % of women in Japan aged 50 and older felt at risk for developing osteoporosis in the future, far fewer than expected by epidemiologists. Risk perception was only loosely related to epidemiological risks for fracture, indicating a need for patient education.