The posibility of influence of frax score questionnaire on early diagnosis and prevention of osteoporosis

Abstract

Modern forms of life marked by the sedentary habits and fast food, and with an extended life of humanity have led to the increasing occurrence of people with osteoporosis at a younger age. Osteoporosis is a devastating disease of the skeletal system characterized by low bone mass and changes in bone micro-architecture structure itself (1). It is characterized by reduced weight per unit volume normally mineralized bone, corresponding to body size, age, sex and racial affiliation. Such changes in the structure of bones lead to an increased risk of breaking bones (2). Osteoporosis as a disease is a silent epidemic because bone loss may be present dozens of years before the appearance of the symptoms. As a disease, it is usually diffusely distributed, and specific localization of fracture is the wrist, spine and neck of the femur. Often it is called the "silent epidemic" because of the lack of signs and symptoms until the first fracture. Fractures lead to reduced quality of life, prolongation of hospitalization until the long-term institutionalization and death (3). The World Health Organization (WHO) has defined osteoporosis as a reduction in bone mineral density of more than 2.5 standard deviations compared to healthy young population, and is determined by densitometry as the only method for diagnosing the disease and monitoring the flow treatment. Today, osteoporosis has epidemiological proportions in the world, and although it is difficult to define the size of the problem, because of the way the formation and detection of the disease, the data shows that there are 25 million women and 12 million men in the world suffering from this disease. Osteoporosis as a disease is a major medical, social and economic problem (4). In Croatia, there is no registry of patients with osteoporosis, nor a fracture register in people diagnosed with osteoporosis. However, in a study that dealt with 6,000 people aged 20-70 years respondents from Croatia participated along with respondents from 13 countries. What was discovered is that respondents from Croatia have similar bone mass as well as subjects of European countries. It is estimated that in Croatia, 90,000 men and 77,000 women has a fracture of the spine after 55 years of age (5). The most effective way to treat osteoporosis is actually working on the prevention of early youth. Numerous studies have shown if people exercise and consume diet enriched with calcium, they have significantly reduced risk of osteoporosis and fractures, which is considered the most effective method of prevention (6). The number of patients is growing daily and in 2010 the number of patients in the United States at the age of 50 years was 99 million (6); therefore the World Health Organization (WHO) in the decade of combat with osteoporosis have confided world experts to find "tools" for the prevention and "fight" against the disease. Because of the wide extent of the problem, WHO in the decade from 2000 to 2010, in which it dedicated to "fight" against osteoporosis, has accepted FRAX score as a possibility and the way in which patients can calculate the ten-year risk of fracture, and thus help prevent and reduce the number of people with osteoporosis (7).

In that period it was confirmed that the safest diagnostic test for the registration and monitoring the course of treatment is densitometry which was set by the World Health Organization (WHO) as a guideline for diagnosing osteoporosis. However, in this period, in order to assist in the prevention and assessment of possible risks of fractures was placed the Fracture Risk Assessment Tool (FRAX score) computerized calculator.