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Men Far Less Likely to Screen for Osteoporosis or Take Preventive Steps

Survey shows physicians are also less likely to suggest screening for men

Older males are far less likely to take preventive measures against osteoporosis or accept recommendations for screening, according to research by geriatricians at North Shore-LIJ Health System in New York.

Geriatric fellow Irina Dashkova, MD, led a cross-sectional survey of 146 older adults in New York and Florida that showed gender differences in perspectives, beliefs, and behaviors surrounding osteoporosis, which primarily affects women but also affects up to 2 million American men. Another 8 million to 13 million men in the United States have low bone mineral density (osteopenia), a precursor to osteoporosis.

While most women would accept osteoporosis screening if offered, less than 25% of men would, the survey found. Women were also more than four times as likely as men to take preventive measures against osteoporosis, such as taking calcium and vitamin D supplements to strengthen bones.

Among the 146 survey respondents, roughly one-third were men with an average age of 72. More than 70% were white. Risk factors were more common in men than women — smoking (69.2% versus 30.9%), sun exposure (67.8% versus 29.6%), and family history of osteoporosis (22.0% versus 3.6%).

A diagnosis of osteopenia/osteoporosis was more common in women (35.6% versus 7.3%). Women more often viewed osteoporosis screening as “useful/very useful” than males (84.4% versus 49.1%). Physicians recommended osteoporosis screening more often for women than men (43.8% versus 9.1%) and women were screened significantly more frequently (52.8% versus 9.1%).

Women were also more likely to accept screening tests (76.7% versus 41.8%). Finally, women were significantly more likely to supplement with calcium (68.1% versus 20.0%) and vitamin D (76.9% versus 30.9%).

"We were surprised at how big a difference we found between men and women regarding osteoporosis," said Dr. Dashkova. The study is scheduled for presentation at The American Geriatrics Society's 2015 Annual Scientific Meeting, which will take place in Washington, DC, from May 15 to 17.

“We know from research that when men suffer fractures, their mortality is higher than in women and that severe medical consequences and loss of independence are much more prevalent in men," she said. "In our environment, you just get this perception that osteoporosis is a women's problem. This has to be changed, and the sooner the better."

More than 10 million Americans suffer from osteoporosis — raising their risk for serious bone fractures ‑ and another 43 million have low bone mineral density, according to the National Osteoporosis Foundation. Prior research showed that 13% of white men in the United States more than 50 years of age will experience at least one osteoporosis-related fracture during their lifetime.

The risk of death after sustaining a hip fracture is twice as high in men compared to women, and loss of independence is also more common in males. Some medical conditions and drugs that can affect osteoporosis risk are male-specific, such as prostate cancer drugs that affect the production of testosterone or the way it works in the body.

Dr. Dashkova's mentoring author, Gisele Wolf-Klein, MD, Director of Geriatric Education and Program Director for the Geriatric Fellowship at North Shore-LIJ, noted that osteoporosis testing involves a painless, quick procedure known as a DXA scan that shouldn't be considered fearsome. But health care providers also aren't encouraging men to undergo screening as often as they should, she said.

Sources: North Shore-LIJ Health System; May 15, 2015; Journal of the American Geriatrics Society (paper abstracts); April 2015.

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