The Treatment Gap in Osteoporosis: Fewer Than 20% of High-Risk Patients Receive Care

A 2021 review published in the Journal of Clinical Medicine examined one of the most paradoxical problems in modern medicine: effective osteoporosis treatments exist, but the vast majority of patients who need them never receive them. The numbers are difficult to reconcile. Of the estimated 200 million women worldwide with osteoporosis, fewer than 20% receive a diagnosis. Of those diagnosed, fewer than 35% receive treatment — even after sustaining a fragility fracture. And of those who start treatment, fewer than half continue beyond six months. The treatment gap has actually widened over the past decade, increasing from 55% in 2010 to over 70% by 2019 in European data.

The GLOW study, involving over 60,000 older women across 10 countries, demonstrated that more than 80% of women with a fragility fracture did not receive osteoporosis treatment in the year following the fracture. This is the equivalent of diagnosing diabetes and then not prescribing insulin — the condition is known, the intervention is proven, and nobody acts.

Why This Matters for Midlife Health

The treatment gap is not primarily a knowledge problem — it is a system problem. Primary care visits are short. Osteoporosis has no symptoms until a fracture happens. Screening is not always prioritized. And patients often do not know they should be asking about bone health during their 50s. The result is that millions of people at risk go unidentified, and millions who are identified go untreated. For individuals in midlife, the takeaway is clear: the system may not catch this for you. You need to be an active participant in your own bone health assessment.

The Tracking Connection

Kairos™ exists in part because of gaps like this one. When a patient walks into an appointment with a documented history — symptoms tracked over months, risk factors cataloged, previous DXA results organized, family history recorded — the provider has no choice but to engage with the data. Tracking does not replace clinical judgment, but it eliminates the most common reason bone health gets overlooked: it never comes up. Making it come up is the first step toward closing the treatment gap, one patient at a time.