Summary
It is likely that by 2044 biomedical and public health forces will be able to control bony fragility to a substantially greater degree than we have succeeded in doing today, but that demographic and lifestyle forces already at work will offset those gains, perhaps substantially. On the other hand, economic and social forces outside of our control will decrease the prevalence of skeletal fragility - harshly, I fear - either by strengthening old bones the ard way, or by decreasing the numbers of the elderly, or both. The final outcome will be the algebraic sum of the effects of these countervailing forces, which is impossible to estimate with any assurance. My guess is that osteoporosis will be less of a problem in 2044, though, unfortunately, for the wrong reasons.
Article PDF
Avoid common mistakes on your manuscript.
References
Dent CE. Keynote address: Problems in metabolic bone disease. In: Frame B, Parfitt AM, Duncan H, editors. Clinical aspects of metabolic bone disease. Amsterdam: Excerpta Medica, 1973:1–7.
US Bureau of the Census. Current population reports, P25-1092, Population projections of the United States, by age, sex, race, and hispanic origin: 1992–2050. US Government Printing Office, Washington, DC, 1992.
Melton LJ III, O'Fallon WM, Riggs BL. Secular trends in the incidence of hip fractures. Calcif Tissue Int 1987;41:57–64.
Obrant KJ, Bengnér U, Johnell O, Nilsson BE, Sernbo I. Increasing age-adjusted risk of fragility fractures: a sign of increasing osteoporosis in successive generations? Calcif Tissue Int 1989;44:157–67.
Lau EMC, Cooper C, Donnan S, Barker DJP. Incidence and risk factors for hip fractures in Hong Kong Chinese. In: Christiansen C, Overgaard K, editors. Osteoporosis 1990. Copenhagen: Osteopress ApS, 1990:66–70.
Thomas L. The technology of medicine. In: The lives of a cell. New York: Viking Press, 1974.
Dempster DW, Cosman F, Parisien M, Shen V, Lindsay R. Anabolic actions of parathyroid hormone on bone. Endocr Rev 1993;14:690–709.
Pak CYC, Sakhaee K, Piziak V, Peterson RD, Breslau NA, Boyd P, et al. Randomized controlled trial of slow-release sodium fluoride in the management of postmenopausal osteoporosis. Ann Intern Med 1994;120:625–32.
Consensus Development Conference. Diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 1993;94:646–50.
Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Eng J Med 1992;327:1637–42.
Heikinheimo RJ, Inkovaara JA, Harju EJ, et al. Annual injection of vitamin D and fractures of aged bones. Calcif Tissue Int 1992;51:105–10.
Chevalley T, Rizzoli R, Nydegger V, et al. Effects of calcium supplement on femoral bone mineral density and vertebral fracture rate in vitamin D replete elderly patients with and without a recent hip fracture: a prospective placebo-controlled study. J Bone Miner Res 1992;7:S322.
Paganini-Hill A, Ross RK, Gerkins VR, Henderson BE, Arthur M, Mack TM. Menopausal estrogen therapy and hip fractures. Ann Intern Med 1981;95:28–31.
Kiel DP, Felson DT, Anderson JJ, Wilson PWF, Moskowitz MA. Hip fracture and the use of estrogens in postmenopausal women. N Engl J Med 1987;317:1169–74.
Naessén T, Persson I, Adami H-O, Bergström R, Bergkvist L. Hormone replacement therapy and the risk for hip fracture. Ann Intern Med 1990:113:95–103.
Draper MW, Flowers DE, Huster WJ, Neild JA. Effects of raloxifine (LY139481 HC1) on biochemical markers of bone and lipid metabolism in healthy postmenopausal women. In: Christiansen C, Riis B, editors. Proceedings of fourth international symposium on osteoporosis and consensus conference, Hong Kong, 1993. Aalborg, Denmark: Handelstrykkeriet, Aalborg ApS, 1993:119–21.
Teilhard de Chardin, P. The phenomenon of man. New York: Harper and Row, 1959:121.
Pauling L, Itano HA, Singer SJ, Wells I. Sickle cell anemia, a molecular disease. Science 1949;110:543–8.
Tucker RF. ‘Holographic’ science needs to meet energy needs. Sci Am 1990;[Mar]:128.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Heaney, R.P. Osteoporosis-2044. Osteoporosis Int 4, 233–237 (1994). https://doi.org/10.1007/BF01623346
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01623346