Skip to main content

Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study


Musculoskeletal diseases, especially osteoarthritis (OA) and osteoporosis (OP), impair activities of daily life (ADL) and quality of life (QOL) in the elderly. Although preventive strategies for these diseases are urgently required in an aging society, epidemiological data on these diseases are scant. To clarify the prevalence of knee osteoarthritis (KOA), lumbar spondylosis (LS), and osteoporosis (OP) in Japan, and estimate the number of people with these diseases, we started a large-scale population-based cohort study entitled research on osteoarthritis/osteoporosis against disability (ROAD) in 2005. This study involved the collection of clinical information from three cohorts composed of participants located in urban, mountainous, and coastal areas. KOA and LS were radiographically defined as a grade of ≥2 by the Kellgren–Lawrence scale; OP was defined by the criteria of the Japanese Society for Bone and Mineral Research. The 3,040 participants in total were divided into six groups based on their age: ≤39, 40–49, 50–59, 60–69, 70–79, and ≥80 years. The prevalence of KOA in the age groups ≤39, 40–49, 50–59, 60–69, 70–79, and ≥80 years 0, 9.1, 24.3, 35.2, 48.2, and 51.6%, respectively, in men, and the prevalence in women of the same age groups was 3.2, 11.4, 30.3, 57.1, 71.9, and 80.7%, respectively. With respect to the age groups, the prevalence of LS was 14.3, 45.5, 72.9, 74.6, 85.3, and 90.1% in men, and 9.7, 28.6, 41.7, 55.4, 75.1, and 78.2% in women, respectively. Data of the prevalence of OP at the lumbar spine and femoral neck were also obtained. The estimated number of patients with KOA, LS, and L2–L4 and femoral neck OP in Japan was approximately 25, 38, 6.4, and 11 million, respectively. In summary, we estimated the prevalence of OA and OP, and the number of people affected with these diseases in Japan. The ROAD study will elucidate epidemiological evidence concerning determinants of bone and joint disease.

This is a preview of subscription content, access via your institution.

Fig. 1


  1. Ministry of Health, Labour and Welfare (2007) The outline of the results of National Livelihood Survey 2007.

  2. Muraki S, Yamamoto S, Ishibashi H, Nakamura K (2006) Factors associated with mortality following hip fracture in Japan. J Bone Miner Metab 24:100–104

    Article  PubMed  Google Scholar 

  3. Jornell O, Kanis JA, Oden A, Sembo I, Redlund-Johnell I, Petterson C, De Laet C, Jonsson B (2004) Mortality after osteoporotic fractures. Osteoporosis Int 15:38–42

    Article  Google Scholar 

  4. Tamaki M, Koga Y (1994) Osteoarthritis of the knee joint: a field study (in Japanese). Nippon Seikeigeka Gakkai Zasshi 68:737–750

    PubMed  CAS  Google Scholar 

  5. Yoshimura N, Campbell L, Hashimoto T, Kinoshita H, Okayasu T, Coggon D, Croft P, Cooper C (1998) Acetabular dysplasia and hip osteoarthritis in Britain and Japan. Br J Rheumatol 37:1193–1197

    Article  PubMed  CAS  Google Scholar 

  6. Yoshimura N, Dennison E, Wilman C, Hashimoto T, Cooper C (2000) Epidemiology of chronic disc degeneration and osteoarthritis of the lumbar spine in Britain and Japan: a comparative study. J Rheumatol 27:429–433

    PubMed  CAS  Google Scholar 

  7. Yoshida S, Aoyagi K, Felson DT, Aliabadi P, Shindo H, Takemoto T (2002) Comparison of the prevalence of radiographic osteoarthritis of the knee and hand between Japan and the United States. J Rheumatol 29:1454–1458

    PubMed  Google Scholar 

  8. Yoshimura N, Hashimoto T, Morioka S, Sakata K, Kasamatsu T, Cooper C (1998) Determinants of bone loss in a rural Japanese community. The Taiji Study. Osteoporos Int 8:604–610

    Article  PubMed  CAS  Google Scholar 

  9. Yoshimura N, Kinoshita H, Danjoh S, Takijiri T, Morioka S, Kasamatsu T, Sakata K, Hashimoto T (2002) Bone loss at the lumbar spine and the proximal femur in a rural Japanese community, 1990–2000: the Miyama study. Osteoporos Int 13:803–808

    Article  PubMed  CAS  Google Scholar 

  10. Fujiwara S, Kasagi F, Masunari N, Naito K, Suzuki G, Fukunaga M (2003) Fracture prediction from bone mineral density in Japanese men and women. J Bone Miner Res 18:1547–1553

    Article  PubMed  Google Scholar 

  11. Kwon J, Suzuki T, Yoshida H, Kim H, Yoshida Y, Iwasa H, Sugiura M, Furuna T (2007) Association between change in bone mineral density and decline in usual walking speed in elderly community-dwelling Japanese women during 2 years of follow-up. J Am Geriatr Soc 55:240–244

    Article  PubMed  Google Scholar 

  12. Tamaki J, Iki M, Hirano Y, Sato Y, Kajita E, Kagamimori S, Kagawa Y, Yoneshima H (2008) Low bone mass is associated with carotid atherosclerosis in postmenopausal women: The Japanese Population-Based Osteoporosis (JPOS) Cohort Study. Osteoporos Int (in press) (Epub ahead of print: 22 May 2008)

  13. Nakamura T (2007) Japanese Guidelines for the Prevention and Treatment of Osteoporosis (2006 edition) and its significance (in Japanese). Nippon Rinsho 65(Suppl 9):s29–s34

    Google Scholar 

  14. Yamamoto I (1999) Estimation for the number of patients of osteoporosis in Japan (in Japanese). Osteoporosis Jpn 7:10–11

    Google Scholar 

  15. Japanese Official Statistics, Ministry of Internal Affairs and Communications (2005) Population Census 2005.

  16. Shimada H, Lord SR, Yoshida H, Kim H, Suzuki T (2007) Predictors of cessation of regular leisure-time physical activity in community-dwelling elderly people. Gerontology 53:293–297

    Article  PubMed  Google Scholar 

  17. Kellgren JH, Lawrence LS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502

    Article  PubMed  CAS  Google Scholar 

  18. Yoshimura N, Kakimoto T, Nishioka M, Kishi T, Iwasaki H, Niwa T, Morioka S, Sakata T, Hashimoto T (1997) Evaluation of reproducibility of bone mineral density measured by dual energy X-ray absorptiometry (Lunar DPX-L). J Wakayama Med Soc 48:461–466

    CAS  Google Scholar 

  19. Orimo H, Hayashi Y, Fukunaga M, Sone T, Fujiwara S, Shiraki M, Kushida K, Miyamoto S, Soen S, Nishimura J, Oh-Hashi Y, Hosoi T, Gorai I, Tanaka H, Igai T, Kishimoto H (2001) Osteoporosis Diagnostic Criteria Review Committee: Japanese Society for Bone and Mineral Research. Diagnostic criteria for primary osteoporosis: year 2000 revision. J Bone Miner Metab 19:331–337

    Article  PubMed  CAS  Google Scholar 

  20. Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF (1987) The prevalence of knee osteoarthritis in the elderly. The Framingham Osteoarthritis Study. Arthritis Rheum 30:914–918

    Article  PubMed  CAS  Google Scholar 

  21. Hart DJ, Spector TD (1993) The relationship of obesity, fat distribution and osteoarthritis in women in the general population: the Chingford Study. J Rheumatol 20:331–335

    PubMed  CAS  Google Scholar 

  22. Muraki S, Oka H, Akune T, Mabuchi A, En-Yo Y, Yoshida M, Saika A, Suzuki T, Yoshida H, Ishibashi H, Yamamoto S, Nakamura K, Kawaguchi H, Yoshimura N (2009) Prevalence of radiographic lumbar spondylosis and its association with low back pain in the elderly of population-based cohorts: the ROAD study. Ann Rheum Dis (in press) (Epub ahead of print: 21 Aug 2008)

  23. Yoshimura N (2008) Establishment of large-scale population based cohort for prevention of osteoporosis: the ROAD Project (in Japanese). Riumachi-ka 39:465–467

    Google Scholar 

  24. Nakamura K (2008) Locomotive syndrome in an aging society (in Japanese). J Jpn Orthop Assoc 82:1–2

    Google Scholar 

  25. Ministry of Health, Labour and Welfare. The report of National Health and Nutrition Survey 2005.

  26. Lementowski PW, Zelicof SB (2008) Obesity and osteoarthritis. Am J Orthop 37:148–151

    PubMed  Google Scholar 

  27. De Laet C, Kanis JA, Odén A, Johanson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, McCloskey EV, Mellstrom D, Melton LJIII, Meunier PJ, Pols HA, Reeve J, Silman A, Tenenhouse A (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338

    Article  PubMed  Google Scholar 

Download references


This work was supported by Grants-in-Aid for Scientific Research: B20390182 (Noriko Yoshimura), C20591737 (Toru Akune), C20591774 (Shigeyuki Muraki), and Young Scientists A18689031 (Hiroyuki Oka), and Collaborating Research with NSF 08033011-00262 (Director, Noriko Yoshimura) from the Ministry of Education, Culture, Sports, Science and Technology, H17-Men-eki-009 (Director, Kozo Nakamura), H18-Choujyu-037 (Director, Toshitaka Nakamura), and H20-Choujyu-009 (Director, Noriko Yoshimura) from the Ministry of Health, Labour and Welfare in Japan. This study was also supported by grants from the Japan Osteoporosis Society, Nakatomi Foundation (Noriko Yoshimura) and research aid from the Japanese Orthopaedic Association (Director, Hiroshi Kawaguchi). The sponsors had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. The authors thank Mrs. Tomoko Takijiri, Mrs. Kumiko Shinou, and other members in the public office in Hidakagawa Town; and Mrs. Tamako Tsutsumi, Mrs. Kanami Maeda, and other members in the public office in Taiji Town for their assistance in the locating and scheduling of participants for examinations. We also express sincere appreciation to Professors Eric Orwoll and Steven Cummings for their fruitful advice on the establishment of the cohort design and selection of items for the questionnaire.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Noriko Yoshimura.

About this article

Cite this article

Yoshimura, N., Muraki, S., Oka, H. et al. Prevalence of knee osteoarthritis, lumbar spondylosis, and osteoporosis in Japanese men and women: the research on osteoarthritis/osteoporosis against disability study. J Bone Miner Metab 27, 620–628 (2009).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: