title: Ultrasonometric profiling of incidence and risk of osteoporosis in rural women.
abstract: BACKGROUND
  It is estimated that over 200 million people worldwide have osteoporosis. The prevalence of osteoporosis is continuing to escalate with the increasingly aging population. The major complication of osteoporosis is an increase in fragility fractures leading to morbidity, mortality, and decreased quality of life. This investigation profiled the incidence and risk of osteoporosis in adult women from a rural setting using ultrasonic bone scanning technology.
  
  
  METHODS
  Between 2001 and 2005, adult female subjects (n = 323) in the age range of 40-87 were drawn from an independent, community dwelling, convenience sample. Bone mineral density T-scores were evaluated using heel ultrasonometry. Demographic and risk factor data, Merck Osteoporosis Evaluation SCORE questionnaire data, and the Osteoporosis Risk Assessment questionnaire data were analyzed.
  
  
  RESULTS
  Results of these scans indicate that 25% of the total population had a T-score < or = -1.0, implying a 1.5- to 2.0-fold increase in risk ratio of hip or spinal fracture for each standard deviational decrease. Age at menopause and weight had a positive correlation with T-scores. While the overall scores on the Merck SCORE questionnaire were inversely correlated to T-scores, no significant correlation was found between the Osteoporosis Risk Assessment questionnaire and T-score data. Additionally, women who had taken estrogen had significantly higher T-scores (p = 0.038) than those who had not.
  
  
  CONCLUSIONS
  That approximately 25% of this sample has low bone mass or osteoporosis underscores the importance of early screening in order to develop preventative awareness and provide education on bone health management. This finding has particularly important ramifications, since the sample was rural women, who typically have limited access to diagnostic bone density procedures.
authors.affiliation: Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA. shg13@case.edu
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Gueldner
authors.forename: Geraldine R
authors.initials: GR
authors.lastname: Britton
authors.forename: Guruprasad
authors.initials: G
authors.lastname: Madhavan
authors.forename: Carolyn S
authors.initials: CS
authors.lastname: Pierce
authors.forename: Theresa N
authors.initials: TN
authors.lastname: Grabo
authors.forename: Janice
authors.initials: J
authors.lastname: Penrod
authors.forename: Sheri A
authors.initials: SA
authors.lastname: Stucke
authors.forename: Chin-Fang
authors.initials: CF
authors.lastname: Liu
mesh_terms: D015502:Absorptiometry, Photon / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D018570:Risk Assessment / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000458:organization & administration; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*; D016387:Women's Health; D014932:Women's Health Services / Q000458:organization & administration