At present, the world is experiencing the greatest demographic changes in human history and, with the increase of average lifetime, we have entered a period of a rapidly aging population. China faces the same situation. In 2013, the population in China aged over 60 years accounted for about 15% of the total population, and it is estimated that the population aged over 60 years will reach 25% by 2050.
The direct consequence of the longevity miracle will be an outbreak of disease that afflicts the elderly. In the absence of systematic and comprehensive interventions, these diseases will seriously affect health‐ and social‐care systems around the world. Among the diseases, osteoporosis and the following fragility fractures of the elderly will be pioneers of these diseases.
Hip fracture is the most serious type of fragility fracture in the elderly with 2.7 million new cases worldwide in 2010, and it is conservatively estimated that the number will rise to 4.5 million by 2050. Although all countries will be affected, Asia will first bear the growing burden of disease: By the middle of this century, about half of all hip fracture cases are expected to occur in Asia. Compared with other countries, the incidence of hip fracture in the elderly in China is relatively low, but due to the large population base in China, the number of hip fracture cases per year is considerable.
By 2050, the number of new hip fracture patients in China is expected to reach 1.079 million. The costs associated with fragility fractures are also staggering: In 2010, the cost of osteoporosis in Europe was 37 billion euros; in the USA, this cost is estimated to be 22 billion dollars in 2020.
If health‐ and social‐care systems are to deal with this critical situation, strong strategies must be developed and a team of health professionals must be formed. The main strategies include: improving the current management of all fragility fractures, striving to restore functional abilities and quality of life, and preventing subsequent fractures, ensuring that the first fracture is the last fracture!
Recently, Injury, an authoritative global medical journal, released the Global Call to Action to improve the care of patients with fragility fractures, which is a very important step towards achieving this vision. The Global Call to Action also calls for specific actions in different sectors, such as patient and patient advocacy organizations, individual health workers, health professional societies, governmental organizations, insurers, health systems and medical practices, and industry. The Global Call to Action calls for changes in the following areas of treatment for fragility fractures:
acute multidisciplinary care for the person who suffers a hip, clinical vertebral, or other major fragility fracture;
rapid secondary prevention after first occurrence of all fragility fractures, including those in younger people as well as those in older persons, to prevent future fractures; and
ongoing post‐acute care of people whose ability to function is impaired by hip and major fragility fractures.
The Global Call to Action, launched by the Fragility Fracture Network (FFN), has been endorsed by 81 academic organizations around the world, including several medical professions related to fragility fractures. Its main author, Professor Karsten E. Dreinhofer, has pointed out that “fragility fractures can seriously damage the quality of life of patients and push our overwhelmed health systems to the brink of collapse.”
For the first time, the Global Call to Action has shown that all the world's leading organizations are aware of the need to work together on a new scale. The World Health Organization (WHO) has declared 2020‐2030 as the “decade of aging health,” and later this year, the United Nations (UN) will hold its third high‐level meeting on non‐communicable diseases. The authors of the Global Call to Action have emphasized that the WHO and the UN are likely to consider the recommendations contained in the Global Call to Action and to become promoters of global initiatives.
Professor Wang Manyi, President of FFN‐China from the Department of Orthopaedics and Traumatology at Beijing Jishuitan Hospital, has pointed out that the Global Call to Action has received support from many academic organizations in China, such as those specializing in orthopedics, geriatrics, and rehabilitation. This indicates that the relevant academic organizations in China have reached an unprecedented consensus on the treatment of fragility fracture in the elderly, and will definitely promote the implementation of the best treatment scheme for fragility fractures.
On October 21, 2018, the first day after World Osteoporosis Day, FFN‐China successfully held the Forum on the Prevention and Treatment of Fragility Fracture with the support of UCB China. As a support and practice of the global Call to Action, this forum gathered many national influential experts in the field of fragility fracture, brought about hot discussion on the latest progress and frontier topics in the field of fragility fractures, and fully demonstrated the achievements and challenges of this field in China.
See specific contents of the Global Call to Action at: http://www.fragilityfracturenetwork.org/CtA
The full text of the Global Call to Action is available at the Injury website: https://www.injuryjournal.com/article/S0020-1383(18)30325-5/fulltext