FacilitatING optimal
fragility fracture
management across Asia Pacific

APFFA’s vision is to deliver effective care, fewer fractures and better outcomes for people living in Asia Pacific.

Formed on November 29, 2018, the Asia Pacific Fragility Fracture Alliance (APFFA) comprises seven global and regional member organisations from the geriatrics, orthopaedics, osteoporosis and rehabilitation sectors.

The organisation’s primary mission is to drive policy change, improve awareness and change political and professional mindsets to facilitate optimal fragility fracture management across Asia Pacific (APAC).

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National Hip
Fracture Registries

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Explore our new
Education Directory

A curated collection of materials from the Asia-Pacific region supporting education on osteoporosis and fracture prevention for a range of audiences

Simply search and identify resources by target audience, topic, format, source organisation, date and language

Learn from best practice from your peers across Asia Pacific, and globally by accessing shared materials, without duplication of effort

Review and localise these materials according to your needs

explore the directory

Latest news

Call to embed roadmaps for acute and long-term fragility fracture care in the Asia Pacific

August 29, 2022

As the Asia Pacific region is set to bear the brunt of the global burden of fragility fractures by mid-century, clear, measurable, national action plans...

New Zealand’s report card on fragility fractures: a review of BoneCare 2020

August 8, 2022

According to a new review, a significant proportion of the systematic approach to care and prevention of fragility fractures proposed in Osteoporosis New Zealand’s BoneCare 2020...

Co-author, Professor Takeshi Sawaguchi, Toyama Municipal Hospital, Japan (6)

Appeal for orthopaedic surgeons to more proactively lead and champion bone health

July 13, 2022

Each year World Osteoporosis Day, which falls on October 20, offers an important reminder to all bone-related stakeholders – orthopaedic surgeons, geriatricians, physicians, paramedics, patients,...

New Zealand raises the bar on growth & refinement of FLS

June 28, 2022

During the pandemic year 2020, New Zealand’s Fracture Liaison Service (FLS) expanded and consolidated to deliver better, broader, secondary fracture prevention in order to minimise...

Study analyses backbone of novel care for fragility fractures in New South Wales, Australia

June 3, 2022

Osteoporotic fractures are a major and growing public health problem worldwide due to the ageing population and associated morbidities that increase fracture risk.1,2,3 In Australia,...

The APCO Bone Health QI Tool Kit

May 27, 2022

Helping to stem the tide of fractures in the Asia Pacific – the world’s most populated and fastest ageing region The Asia Pacific Consortium on...

Co-author, Professor Takeshi Sawaguchi, Toyama Municipal Hospital, Japan

Hip fracture multi-modal care breaking new ground in Japan

May 17, 2022

Japan is a super-ageing society. While its population boasts the world’s second-longest life expectancy, it does however, have a growing number of older people living...

Snapshot of the global landscape of PFC programs

April 14, 2022

Fragility fractures are associated with high rates of disability, loss of independence, reduced quality of life for both patients and their carers, not to mention...

Looking down the 10-year pipeline for bone fractures

April 5, 2022

Patients living with osteoporosis are projected to increase in magnitude in the next decade. This means a crisis of bone fractures along with the forecasted...

New review of the global approach to rehabilitation following an osteoporotic fragility fracture

February 23, 2022

Almost 40 per cent of individuals who experience a hip fracture are unable to walk, or will be institutionalised within a year post-fracture. Furthermore, 60...

Decade of Healthy Ageing

The number and proportion of the world’s population aged 60 years and above is growing at an unprecedented rate, and is set to accelerate especially in developing countries. An ageing population will continue to affect all aspects of society, with little evidence suggesting older people today are enjoying better health than previous generations.¹

In a bid to address the situation, the World Health Organization (WHO) has announced the Decade of Healthy Ageing 2020 - 2030 – a 10-year-long concerted global action initiative designed to improve the lives of older people, their families, and their respective communities.¹

Country/region statistics

(Hover to view)

Australia

Osteoporosis affects about half of all Australian women over the age of 50, and causes more hospitalisations than heart attacks, strokes and breast cancer combined.²

In Australia, four-times more women aged 50 and above have osteoporosis or osteopenia than men of the same age .³

By 2022, an estimated 6.2 million Australians over 50 years of age will have osteoporosis or osteopenia, a 31 per cent increase from 2012.⁴

In 2012, the total costs of osteoporosis and osteopenia among Australians aged over 50 was AUD$2.75 billion – a figure which is projected to increase to AUD3.84 billion by 2022.⁴

Japan

Forty-five per cent of the Japanese population was aged over 50 years in 2013, with a life expectancy of 84 years.

The proportion of the country’s population aged over 50 years is anticipated to increase to 51 per cent of the population in 2025, and 57 per cent by 2050.⁵

China

In 2013, the number of people aged 60 years and above hit 200 million in China (representing 26 per cent of the population), which is projected to increase to 49 per cent or 636 million by 2050.⁵

Studies have estimated that around 13 per cent of Mainland Chinese adults have osteoporosis.⁵

Projections suggest the total number of osteoporosis-related fractures in China will increase from 2.33 million in 2010, to 5.99 million in 2050.⁶

Costs of osteoporosis-related fracture cases in China are projected to increase from US9.5 billion in 2010 to US25.4 billion in 2050.⁶

Malaysia

In 2013, just under one-fifth (18 per cent) of Malaysia’s population was aged 50 years and above. This figure is projected to increase to 32 per cent by 2050, accounting for nearly one-third of Malaysia’s population.⁵

Osteoporosis remains under-diagnosed and undertreated in Malaysia, although the prevalence is not well known, or documented.⁵

Malaysia is projected to have the highest (3.55-fold) increase in the total number of hip fractures by 2050.⁷

Taiwan

In 2010, the percentage of the Taiwanese population aged over 65 years was 11 percent of the total population.9 In 2025, the old-age population will account for one-fifth of the entire population.⁹

The cost per hip fracture in Taiwan was estimated to be at USD$3,242.¹⁰

Studies indicate the annual hip fracture rate (392/100,000 for women and 196/100,000 for men, standardised for the world population in 2010) in Taiwan was among the highest worldwide.¹¹

Tragically, in 2009, 11 per cent of women and 18 per cent of men in Taiwan died within 12 months of a hip fracture due to infections related to being bedridden.¹²

Hong Kong

In 2013, 40 per cent of the population of Hong Kong was aged over 50 years. By 2025, projections suggest half of the total population will be aged over 50 years, rising to 60 per cent by 2050.⁵

The 2018 Asian Federation of Osteoporosis Societies (AFOS) study projected the number of hip fractures in Hong Kong to be 9,590 and 27,468 in 2018 and 2050, respectively.⁷

The 2018 AFOS study further estimated the direct medical costs of hip fractures in Hong Kong to be US$85 million, with projected costs of such to increase to US$243 million by 2050.⁷

Singapore

The highest rates of hip fractures in Asia have been reported in Singapore, with a four-to-five-fold increase in incidence over 30 years.⁵

Singapore has a rapidly aging population, with the number of people aged 65 years and above expected to triple from the current 350,000 to 960,000 by the year 2030.⁸

References

World Health Organization. Decade of Healthy Ageing 2020-2030. 2020 [cited Jan 2020]; Available from: https://www.who.int/ageing/decade-of-healthy- ageing.
SOS Fracture Alliance. SOS Fracture Alliance: Making the first break the last. 2018 [cited Jan 2020]; Available from: https://www.sosfracturealliance.org.au/.
Australian Institute of Health and Welfare. Osteoporosis snapshot. 2019 [cited Jan 2020]; Available from: https://www.aihw.gov.au/reports/chronic- musculoskeletal-conditions/osteoporosis/contents/what-is-osteoporosis.
Watts, J., Ambimanyi-Ochom, J, & Sander K, Osteoporosis costing all Australians: A new burden of disease analysis 2012-2022. 2013, Osteoporosis Australia.
International Osteoporosis Foundation, The Asia-Pacific Regional Audit: Epidemiology, costs & burden of osteoporosis in 2013. 2013. p. 1-128.
Si, L., et al., Projection of osteoporosis-related fractures and costs in China: 2010–2050. Osteoporosis International, 2015.
Cheung, C.L., et al., An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study. Osteoporos Sarcopenia, 2018. 4(1): p. 16-21.
Cosman, F., et al., Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2014. 25(10): p. 2359-2381.
Lin, W.-I., The Coming of an Aged Society in Taiwan: Issues and Policies. Asian Social Work and Policy Review, 2010. 4(3): p. 148-162.
Huang, Z., et al,, Epidemiology and Medical Costs of Patients with Hip Fracture at a Medical Center in Central Taiwan. Journal of Emergency Medicine, Taiwan, 2008. 10(3): p. 81-86.

Kanis, J.A., et al., A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporosis International, 2012. 23(9): p. 2239-2256.
Wang, C.-B., et al., Excess mortality after hip fracture among the elderly in Taiwan: A nationwide population-based cohort study. Bone, 2013. 56(1): p. 147-153.