Imminent fracture risk and disability post fracture

Osteoporotic fracture represents a growing public health problem worldwide. Fracture is not benign, being associated with significant risk of future fracture, disability, loss of independence, and premature mortality. This chapter reviews the epidemiology of imminent fracture risk, and its associated outcomes, including disability, institutionalizations, and premature mortality.
Imminent fracture risk occurs predominantly following a prior fracture. Virtually all types of fractures are associated with at least twofold risk of a subsequent fracture, and this risk is highest in the first 2 years following the initial fracture. As well as increased risk of imminent fracture, all fractures are associated with significant disability and premature mortality. While these outcomes are worse for hip and vertebral fractures, nonhip and nonvertebral fractures contribute to a greater population burden due to their high prevalence (>50% of all fractures) and constitute up to 40% of the overall excess mortality. Antiosteoporosis treatment not only reduces fracture risk but may also decrease mortality.