“Men are from Mars”, so March is a good time to think about men, the overlooked minority in osteoporosis. The American Journal of Men’s Health has published a study of osteoporosis screening rates for men over age 70. The results are discouraging.
Osteoporosis screening at age 70 for men with no identified risk factors, and earlier for those with known risk factors, has been recommended by the National Osteoporosis Foundation (NOF) and Medicare since 2008. 25 % of persons known to have osteoporosis are men. Yet we still perceive osteoporosis to be women only . We ignore the male minority.
Only 11.3% of men over 70 were screened by DXA for Bone Mineral Density (BMD) in the group studied. Vertebral Fracture Assessment (VFA) testing was much lower. Full blood tests, including 25-hydroxy Vit D and PTH were even lower.
23.2 % of the men studied did receive some bone protective prescription treatments – primarily Vitamin D3 and calcium supplementation.
Just as all postmenopausal women and all women over 50 should be screened for osteoporosis, so should all men over 70. This study looked at DXA. A full screening for bone health is much better. DXA alone misses many persons who need focussed treatment to avoid osteoporotic fragility fractures.
Men can develope osteoporosis and fragility fractures. Almost one-third of men over 70 with a hip fracture die. This does not need to happen. If we screen for bone health early enough, we can often treat to prevent osteoporosis and prevent fractures.
Jay Ginther, MD