The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations

Abstract

Purpose The total number of older adults in Turkey is striking, amounting to around 8 million, and this translates into considerably higher numbers of cases of osteoporosis (OP) and fractures in older adults. In this article, we outlined the current situation of OP in older adults in Turkey and investigated the differences between Turkey and a representative developed European country (Belgium), in terms of the screening, diagnosis, and treatment of OP. Our intention in this regard was to identify areas in need of improvement and subsequently to make a clear call for action to address these issues. Methods Herein, considering the steps related to the OP approach, we made a complete review of the studies conducted in Turkey and compared with the literature recommendations. Results There is a need for a national osteoporotic fracture registry; measures should be taken to improve the screening and treatment of OP in older males, such as educational activities; technicians involved in dual-energy X-ray absorptiometry (DXA) scanning should undergo routine periodic training; all DXA centers should identify center-specific least significant change values; all older adults should be considered for routine lateral dorsolumbar X-ray imaging for the screening of vertebral fractures while ordering DXA scans; the inclusion of vertebral fracture assessment (VFA) software in DXA assessments should be considered; screening using a fracture risk assessment tool (FRAX) algorithm that is specific to Turkey should be integrated; the fortification of foods with vitamin D is required; the high fracture risk by country-specific FRAX algorithm and the presence of falls/high fall risk should be integrated in reimbursement terms; and finally, more "fracture liaison services" should be established. ConclusionWe suggest that the practical consideration of our suggestions will provide considerable support to the efforts for combating with the adverse consequences of OP in society. This approach can be subsequently modeled for other populations to improve the management of OP globally. KeywordsOsteoporosis • Current situation • Turkey • Older • Improvement Abbreviations BMD Bone mineral density DXA Dual-energy X-ray absorptiometry eGFR Estimated glomerular filtration rate ESCEO Economic evaluation of osteoporosis and osteoarthritis * Gulistan Bahat

The effect of health belief model‐based short interviews in women in the postmenopausal period on the prevention of osteoporosis: A randomized controlled trial

“…In another study conducted to identify the prevalence of osteoporosis and risk factors among Turkish women aged 18-49 years, the measurement of bone mineral density levels indicated that 33% of women were osteopenic and that 6.9% of these women were at medium-high risk of developing osteoporosis (Pinar et al, 2017). In studies conducted in Turkey, it is stated that fractures will increase because of the rapid increase in the elderly population and that there is a need for adult education and awareness studies to establish a national fracture record (Bahat et al, 2021).…”