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Elderly Men Who Fall Should Be Screened for Osteoporosis: Presented at AGS

By Crystal Phend

CHICAGO, I.L. -- May 5, 2006 -- Elderly men who have fallen at least once are more likely to have osteoporosis than men the same age who have not fallen and should be screened for low bone mineral density, according to a study presented here at the American Geriatrics Society 2006 Annual Scientific Meeting (AGS).

"Half of these patients will fall recurrently and therefore deserve more attention as to prevention and early treatment of osteoporosis to improve their quality of life," said presenting author Ima Alimoradi, MD, geriatrics fellow, New York University, New York, New York.

Osteoporosis is less common in men than women, but when osteoporotic hip fractures do occur in men, typically from a fall, they have a higher mortality rate than women, Dr. Alimoradi said in a presentation on May 4^th. There are currently no guidelines for screening bone density in men.

Dr. Alimoradi and colleagues reviewed medical charts of 37 men who were 65 years or older with a history of falls and compared the osteoporosis prevalence in these men with age- and sex-matched national averages.

The study population had all sustained a fall and had at least 1 visit to a Veterans' Administration geriatric clinic in the past 5 years.

Nearly half of the men who had a history of falling had osteoporosis. These men had a significantly higher prevalence of osteoporosis compared with US national averages for 85-year-old men (48.9% vs 13.7%).

Osteoporosis was defined as a reduction in bone mineral density (BMD) value less than 2.5 standard deviations below normal (a T-score of < -2.5) as measured by dual-energy x-ray absorptiometry of the lumbar spine or femoral neck.

In the study, the average BMD was 1.059 g/cm² and the average T-score was -0.564. Femoral neck BMD and T-scores were significantly lower in the group that had osteoporosis than in those who did not. The average age was 84.5 years.

Dr. Alimoradi noted that body mass index (BMI) tended to be lower in men with osteoporosis than in those without (23.1 kg/m² vs 26.2 kg/m²), which may reflect increased malnutrition.

In women, lower body weight is associated with a higher incidence of osteoporosis and those who weigh less than 57 kg (126 lbs) are recommended for bone density screening. However, since men tend to be taller than women, BMI may be a more relevant surrogate in men, Dr. Alimoradi said.

Men with a history of falls also tended to have more osteoporosis risk factors, or so-called 'red flags', including hormone ablation, hyperparathyroidism, compression fraction, and osteopenia seen on x-ray images.

However, only 10 of the 18 men with osteoporosis had these 'red flags', indicating that these factors may not accurately reflect the risk for this population, according to the researchers.


[Presentation title: Prevalence of Osteoporosis in Elderly Men Who Fall. Poster A123]

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