Pongchaiyakul C, 2007.

Burden of Osteoporosis in Thailand

Pongchaiyakul C, 2007.

Women

Female population: 31.6 millions Age >50 yr: 6.7 millions Prevalence of osteoporosis in Thailand 13.6 (FN), 19.8 (LS) 19.3 (FN), 24.7 (LS)…KK Number of osteoporosis: 909,000 (hip) 1.3 millions (LS) Number of hip fracture: 42,000 Death after hip fracture in osteo: 7,140 (1 in 6)..1 yr Total cost of hip fracture Rx: 116,459 /yr Direct cost: 59,882 Direct cost per life-year: 118,168 /yr

Pongchaiyakul C, 2007.

Men

Female population: 30.8 millions Age >50 yr: 5.73 millions Prevalence of osteoporosis in KK+BKK 12.6 (FN), 4.6 (LS) and 3.9 (boths) Number of osteoporosis: 721,770 (hip) 263,500 (LS) Number of hip fracture: 35,133 Death after hip fracture in osteo: 2,747 (1 in 6) in 1 yr Total cost of hip fracture Rx: 116,459 /yr Direct cost: 59,882 Direct cost per life-year: 118,168 /yr

Pongchaiyakul C, 2007.

Mortality after hip fracture

Duration after Fx Mortality(%)

3 mo 9

6 mo 12

12 mo 17

18 mo 23.7

60 mo 29

Pongchaiyakul C, 2007.

Morbidity after hip fracture

Morbidity (%)

Walk without aid 67.9

Walk with aid 10

Can not walk 22.1

Pongchaiyakul C, 2007.

Quality of life : Hip fracture :Khonkaen Study

0

10

20

30

40

50

60

70

normal mild to mod. Marked limit

Overall QoL

0

10

20

30

40

50

60

WOMAC

well moderate disturb

The world population is ageing Population Pyramid in

1995

00-04

10-14

20-24

30-34

40-44

50-54

60-64

70-74

80+

Millions

Age

MALE FEMALE

300 300200 100 100 200

UN Population Division, 1998 Revision

and 2025

Pongchaiyakul C, 2007.

Population Pyramid Summary for THAILAND, 2004 & 2050

The top ten of killers in Thailand 1999

Rank Disease category Deaths % Disease category Deaths %

Males Females

1 HIV/AIDS 37,888 17% Stroke 24,257 15%

2 Stroke 20,330 9% HIV/AIDS 13,271 8%

3 Traffic accidents 19,973 9% Diabetes 12,409 8%

4 Liver cancer 16,231 7% Ischaemic heart disease 8,321 5%

5 COPD ( emphysema) 11,751 5% Liver cancer 7,922 5%

6 Ischaemic heart disease 10,871 5% COPD (emphysema) 5,317 3%

7 Lung cancer 7,415 3% Lower respiratory infect 5,105 3%

8 Diabetes 7,059 3% Tuberculosis 4,478 3%

9 Homicide and violence 6,486 3% Traffic accidents 4,442 3%

10 Cirrhosis 6,458 3% Nephritis & nephrosis 4,142 3%

Osteoporosis ??Osteoporosis ??

Source: Bureau of Health Policy and Plan and Division of Epidemiology, MOPH. 1999

Women 7,140Women 7,140Men 2,741Men 2,741

Top Twenty Causes of Disability Burden in DALYs by sex, Thailand 1999

Rank Males DALY Rank Females DALYs

1 HIV/ AIDS 1,032,313 18 % 1 HIV/ AIDS 459,618

11%

2 Traffic accidents 623,339 11 % 2 Stroke 278,108 6 %

3 Stroke 234,737 4 % 3 Diabetes 269,107

6 %

4 Liver cancer 205,785 4 % 4 Depression 145,236 3 %

5 Homicide and violence 169,624 3 % 5 Traffic accidents 133,424 3 %

6 Suicides 159,948 3 % 6 Low birth weight 123,008 3 %

7 Diabetes 157,487 3 % 7 Liver cancer 121,780 3 %

8 COPD (emphysema) 149,188 3 % 8 Osteoarthritis 120,769 3 %

9 Ischaemic heart disease 141,012 2 % 9 COPD (emphysema) 112,759 3 %

10 Low birth weight 138,438 2 % 10 Ischemic heart disease 102,400

2 %

11 Drugs abuse 138,163 2 % 11 Lower respiratory tract infections 102,080 2 %

12 Alcohol abuse 130,072 2 % 12 Anemia 98,690 2 %

13 Drowing 118,926 2 % 13 Cataracts 95,221 2 %

14 Schizophrenia 114,888 2 % 14 Deafness 87,497 2 %

15 Birth trauma & asphyxia 102,001 2 % 15 Birth trauma & asphyxia 86,729 2 %

16 Cirrhosis 101,167 2 % 16 Schizophrenia 82,631 2 %

17 Depresision 97,799 2 % 17 Dementia 68,908

2 %

18 Anxiety disorders 67,013 2 % 18 Deafiness 95,571 2 %

19 Congenital heart disease 63,082 1 % 19 Lower respiratory tract infections 93,094 2 %

20 Tuberculosis 16,915 1 % 20 Lung cancer 90,847

2 %

Osteoporosis ??Osteoporosis ??

The morbidity burden in Year Lived with Disability (YLDs) by sex and disease group, in Thailand 1999

Chronic Respiratory 6%

Diabetes 5%

Neurological 5%

Other 16%

Musculoskeletal 8%

Mental

Nutritional 6%

Infectious 4%

Injuries 5%

Drug & alcohol 18%

Sense organs 12

Diabetes 7%

Neurological 7%

Infectious 5%

Cardiovascular 3%

Other 13%

Mental 22%

Congenital 3%

Chronic respiratory

Nutritional 8%

Sense organs15%

Musculoskeletal 11%

Males 1.4M YLD Females 1.4M YLD

Chronic Respiratory 6%

Diabetes 5%

Neurological 5%

Other 16%

Musculoskeletal 8%

Mental

15%

Nutritional 6%

Infectious 4%

Injuries 5%

Drug & alcohol 18%

Sense organs 12%

Diabetes 7%

Neurological 7%

Infectious 5%

Cardiovascular 3%

Other 13%

Mental 22%

Congenital 3%

Chronic respiratory5 %

Nutritional 8%

Sense organs15%

Musculoskeletal 11%

Males 1.4M YLD Females 1.4M YLD

Source: Bureau of Health Policy and Plan and Division of Epidemiology, MOPH. 1999

Pongchaiyakul C, 2007.

ร้�อยละของผู้�สูงอาย ไทยท��เป็�นโร้คหร้�อมี�อาการ้ของโร้คท��พบบ�อยจำ าแนกตามีกล �มีอาย พ.ศ . 2537 และ พ.ศ . 2545

โร้ค / อาการ้ของโร้คพ.ศ . 2537 พ.ศ . 2545

ร้วมี 60-64 60-69 70-74 > 75 ร้วมี 60-64 60-69 70-74 > 75

- ป็วดเมี��อย ป็วดหล'ง

- ป็วดข�อ (ข�อเสู��อมี)

- นอนไมี�หล'บ

- เว�ยนศ�ร้ษะ

- โร้คเก��ยวก'บตา

- ความีจำ าเสู��อมี

- ความีด'นโลห)ตสูง/ต �า

-

72.4

44.7

49.2

43.0

27.2

25.0

-

68.5

40.2

46.8

35.6

21.7

22.3

-

73.7

44.8

45.7

40.6

22.9

25.7

-

73.8

46.6

51.6

48.5

32.1

27.4

-

76.9

52.0

56.9

56.0

40.2

26.8

75.1

47.5

38.7

36.8

33.2

29.8

20.0

72.7

42.8

34.1

34.4

27.5

22.3

17.7

74.7

46.7

38.1

35.6

31.1

26.5

20.3

77.8

49.8

42.0

38.7

37.3

33.2

21.9

77.3

54.9

44.9

41.2

42.8

45.2

21.6

Pongchaiyakul C, 2007.

Conclusions Women 1/7 in women with age ≥ 50 yr..osteoporosis 1/22 in osteoporosis…hip fracture Risk of hip Fx: 5-fold increased in osteo. 1/6 of hip fracture death within 1 yr 1/3 of hip fracture death within 5 yr Men 1/8 in men with age ≥ 50 yr..osteoporosis 1/45 in osteoporosis…hip fracture Risk of hip Fx: 6-fold increased in osteo. 1/6 of hip fracture death within 1 yr