Fewer Older Men Assessed, Treated for Osteoporosis
Fewer older men than women, even with higher risk, undergo DXA screening, 25(OH)D measurement
FRIDAY, Feb. 15, 2019 (Pharmacist's Briefing) -- Fewer older men than women undergo evaluation for or management of osteoporosis, according to a study published online Feb. 12 in the Journal of Investigative Medicine.
Radhika Rao Narla, M.D., from the University of Washington in Seattle, and colleagues studied 13,704 older men and women whose 10-year hip fracture risk was assessed by limited FRAX score. Evaluation and treatment were compared for older men and women.
The researchers found that 48 and 88 percent of men aged 75 to 79 and ≥80 years, respectively, had a 10-year hip fracture risk ≥3 percent with age alone as a risk. Fewer older men than older women underwent dual-energy X-ray absorptiometry (DXA; 12 versus 63 percent) and serum 25-hydroxyvitamin D (25[OH]D) measurements (18 versus 39 percent) and received calcium/vitamin D (20 versus 63 percent) and bisphosphonate prescriptions (5 versus 44 percent). The proportion of men with 10-year hip fracture risk of ≥3 percent varied from 69 to 95 percent among older men in the higher-risk category. Compared with older women, fewer older men with higher risk underwent DXA screening (27 to 36 percent) and 25(OH)D measurement (23 to 28 percent), and they received fewer calcium/vitamin D (40 to 50 percent) and bisphosphonate (13 to 24 percent) prescriptions.
"Guidelines and education of providers are inadequate in effectively identifying older men who might benefit from evaluation for osteoporosis and fracture prevention treatment," the authors write.